| The Active Joint Institute | |
|
11762 S State St Suite 110 Draper UT 84020-7155 | |
| (801) 495-3539 | |
| (801) 996-8785 |
| Full Name | The Active Joint Institute |
|---|---|
| Speciality | General Practice |
| Location | 11762 S State St, Draper, Utah |
| Authorized Official Name and Position | Ryan K Riggs (OWNER) |
| Authorized Official Contact | 8016514876 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Active Joint Institute 11762 S State St Suite 110 Draper UT 84020-7155 Ph: (801) 390-0188 | The Active Joint Institute 11762 S State St Suite 110 Draper UT 84020-7155 Ph: (801) 495-3539 |
| NPI Number | 1376810176 |
|---|---|
| Provider Enumeration Date | 11/22/2011 |
| Last Update Date | 02/21/2017 |
| Medicare PECOS PAC ID | 8022279520 |
|---|---|
| Medicare Enrollment ID | O20120410000450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376810176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 6453925-1205 (Utah) | Primary |
| 335E00000X | Prosthetic/orthotic Supplier | (* (Not Available)) | Secondary |
| Provider Name | Ryan K Riggs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669415881 PECOS PAC ID: 4284693342 Enrollment ID: I20070813000424 |
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