Provider Demographics
NPI:1356422828
Name:YEAGER, STUART JOHN (DC)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:JOHN
Last Name:YEAGER
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 1:7086 HIGHLAND DR
Mailing Address - Street 2:SUITE 50
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3766
Mailing Address - Country:US
Mailing Address - Phone:801-943-3355
Mailing Address - Fax:
Practice Address - Street 1:7086 HIGHLAND DR
Practice Address - Street 2:SUITE 50
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-3766
Practice Address - Country:US
Practice Address - Phone:801-943-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT262577-1202111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD6541Medicaid
UT000056218Medicare UPIN