Provider Demographics
NPI:1255429742
Name:JACQUES, FRANCOIX (DC)
Entity type:Individual
Prefix:DR
First Name:FRANCOIX
Middle Name:
Last Name:JACQUES
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 1:1684 REUNION AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-4609
Mailing Address - Country:US
Mailing Address - Phone:801-562-0502
Mailing Address - Fax:801-302-8265
Practice Address - Street 1:1684 REUNION AVE STE 100
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-4609
Practice Address - Country:US
Practice Address - Phone:801-562-0502
Practice Address - Fax:801-302-8265
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT320003-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT870395551005Medicaid