Provider Demographics
NPI:1134528961
Name:MESSENGER, JUDD
Entity type:Individual
Prefix:
First Name:JUDD
Middle Name:
Last Name:MESSENGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 S 1170 W
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-5708
Mailing Address - Country:US
Mailing Address - Phone:801-836-9001
Mailing Address - Fax:
Practice Address - Street 1:28362 LAURA LA PLANTE DR
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-2450
Practice Address - Country:US
Practice Address - Phone:805-870-5066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications