Provider Demographics
NPI:1891149209
Name:WHEATLEY, JANNA G (DC)
Entity Type:Individual
Prefix:DR
First Name:JANNA
Middle Name:G
Last Name:WHEATLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 N 400 E
Mailing Address - Street 2:#294
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414-2240
Mailing Address - Country:US
Mailing Address - Phone:801-644-2489
Mailing Address - Fax:
Practice Address - Street 1:2721 N HWY 89
Practice Address - Street 2:STE100
Practice Address - City:PLEASANT VIEW
Practice Address - State:UT
Practice Address - Zip Code:84404-6258
Practice Address - Country:US
Practice Address - Phone:801-644-2489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT176052-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor