Provider Demographics
NPI:1467784181
Name:FLETCHER, THOMAS REEL (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:REEL
Last Name:FLETCHER
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 1:5801 S FASHION BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6153
Mailing Address - Country:US
Mailing Address - Phone:801-870-4443
Mailing Address - Fax:
Practice Address - Street 1:5801 S FASHION BLVD
Practice Address - Street 2:STE 220
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6153
Practice Address - Country:US
Practice Address - Phone:801-870-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7545378-1202111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician