MEDICARE: NATHAN DAVID MCNEIL D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	9793808-1202	UT

General Provider Information

NPI Number	:	1922557974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN DAVID MCNEIL D.C.

Provider Business Mailing Address
First Line	:	1200 E 3300 S
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84106
Country	:	US
Telephone Number	:	801-948-2850
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 E 3300 S
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84106
Country	:	US
Telephone Number	:	801-948-2850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2016
Last Update Date	:	10/03/2017

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