Cleverley, Jesse Adam
Cleverley, Jesse Adam is an sole proprietor health care provider with primary practice located at 1684 W Reunion Ave Ste 250 , South Jordan UT 84095-4626. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Cleverley, Jesse Adam can be contacted via phone (801) 562-0363.Contact Information
Primary practice address
1684 W Reunion Ave Ste 250
South Jordan UT 84095-4626
Phone: (801) 562-0363
Fax: (801) 562-0347
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | CHIA-851 | Idaho |
| Chiropractic Providers / Chiropractor | 111N00000X | 9213627-1202 | Utah |
Profile Details
| NPI number | 1386785939 |
|---|---|
| LBN Legal business name | Cleverley, Jesse Adam |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 8th, 2007 |
| Last updated | Dec 16th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386785939 | NPPES |
| Idaho | Other | 000010008123 | BLUE SHIELD |
| Idaho | MEDICAID | 806192200 | BLUE SHIELD |
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