Healthcare Provider Details

I. General information

NPI: 1689493405
Provider Name (Legal Business Name): UPRIGHT CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13207 E STATE ROUTE 169 STE B
DEWEY AZ
86327-0018
US

IV. Provider business mailing address

841 S MANZANITA BLVD
DEWEY AZ
86327-7119
US

V. Phone/Fax

Practice location:
  • Phone: 928-499-0069
  • Fax: 928-440-0780
Mailing address:
  • Phone: 208-870-6894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LOGAN BAXTER
Title or Position: OWNER
Credential: DC
Phone: 208-870-6894