Provider Demographics
NPI:1831202282
Name:NEUMANN, ROGER MAX (DC)
Entity type:Individual
Prefix:MR
First Name:ROGER
Middle Name:MAX
Last Name:NEUMANN
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 1:1480 SOUTH ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5108
Mailing Address - Country:US
Mailing Address - Phone:801-292-5611
Mailing Address - Fax:801-292-5579
Practice Address - Street 1:1480 SOUTH ORCHARD DR
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-5108
Practice Address - Country:US
Practice Address - Phone:801-292-5611
Practice Address - Fax:801-292-5579
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT156174 1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000000415Medicare ID - Type Unspecified