Provider Demographics
NPI:1447443452
Name:BATEMAN, CAMERON JACOB (DC)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:JACOB
Last Name:BATEMAN
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 1:1654 W REUNION AVE
Mailing Address - Street 2:STE B
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-4676
Mailing Address - Country:US
Mailing Address - Phone:801-302-9680
Mailing Address - Fax:801-254-4211
Practice Address - Street 1:1654 W REUNION AVE
Practice Address - Street 2:STE B
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-4676
Practice Address - Country:US
Practice Address - Phone:801-302-9680
Practice Address - Fax:801-254-4211
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5121570-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor