Provider Demographics
NPI:1265816953
Name:MECHAM, JORDAN KARL (DC)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:KARL
Last Name:MECHAM
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 1:60 S 300 E
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:UT
Mailing Address - Zip Code:84624-5551
Mailing Address - Country:US
Mailing Address - Phone:435-864-2000
Mailing Address - Fax:435-864-2002
Practice Address - Street 1:60 S 300 E
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:UT
Practice Address - Zip Code:84624-5551
Practice Address - Country:US
Practice Address - Phone:435-864-2000
Practice Address - Fax:435-864-2002
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9407716-1202111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation