NPI 1053801324

Jordan James Radandt

Practitioner Podiatrist Salt Lake City, UT

Practice location

Address: 3130 S Highland Dr # B4, Salt Lake City, UT 84106-3095
Phone: (801) 253-6886
Fax: (801) 253-6888
Mailing address: 4019 W 12600 S STE 120, Riverton, UT 84096-7405

Registered specialties (2)

Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213E00000X Licence 11313930-0501 (UT)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1053801324
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 May 2018
Record last updated: 14 Sep 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.