Provider Demographics
NPI:1629231287
Name:WATTS LLC
Entity Type:Organization
Organization Name:WATTS LLC
Other - Org Name:WATTS CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:DEVIN
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-631-4500
Mailing Address - Street 1:1972 W 5400 S
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84118-1459
Mailing Address - Country:US
Mailing Address - Phone:801-613-4500
Mailing Address - Fax:
Practice Address - Street 1:1972 W 5400 S
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84118-1459
Practice Address - Country:US
Practice Address - Phone:801-613-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT51882401202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty