Healthcare Provider Details

I. General information

NPI: 1871681288
Provider Name (Legal Business Name): RAYMOND DOUGLAS ATKINSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 N 900 E
AMERICAN FORK UT
84003-9183
US

IV. Provider business mailing address

732 APPLE GROVE LN
PLEASANT GROVE UT
84062-3661
US

V. Phone/Fax

Practice location:
  • Phone: 801-785-0284
  • Fax: 801-785-9417
Mailing address:
  • Phone: 801-785-0284
  • Fax: 801-785-9417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5082095-1202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: