NPI 1679502710 · live from the CMS NPI Registry
Jason T Bruse, DPM
Podiatrist in Layton, UT. National Provider Identifier 1679502710, active.
NPI record
| NPI | 1679502710 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 3225 W Gordon Ave Ste 1, Layton, UT 84041 |
| Practice phone | 801-397-6150 |
| Mailing address | Po Box 5546, Denver, CO 80217 |
| Enumerated | July 1, 2006 |
| Last updated | March 7, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | 49404210501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.