Provider Demographics
NPI:1982762050
Name:HAGGART, BRUCE JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:JAMES
Last Name:HAGGART
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 1:3646 S REDWOOD RD
Mailing Address - Street 2:SUITE W-1, MAIL BOX # 2
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-3800
Mailing Address - Country:US
Mailing Address - Phone:801-746-4106
Mailing Address - Fax:
Practice Address - Street 1:3646 S REDWOOD RD
Practice Address - Street 2:SUITE W-1, MAIL BOX # 2
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-3800
Practice Address - Country:US
Practice Address - Phone:801-746-4106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT288382-1202111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation