Provider Demographics
NPI:1235487224
Name:HORSTMAN, CLAYTON ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:ADAM
Last Name:HORSTMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13268 S 5600 W
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-7776
Mailing Address - Country:US
Mailing Address - Phone:303-319-1926
Mailing Address - Fax:
Practice Address - Street 1:13268 S 5600 W
Practice Address - Street 2:
Practice Address - City:HERRIMAN
Practice Address - State:UT
Practice Address - Zip Code:84096-7776
Practice Address - Country:US
Practice Address - Phone:303-319-1926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-22
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014014536111N00000X
CO6907111N00000X
UT11364336-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor