Healthcare Provider Details

I. General information

NPI: 1780632232
Provider Name (Legal Business Name): FROGLEY HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 SOUTH 500 WEST
BOUNTIFUL UT
84010
US

IV. Provider business mailing address

135 SOUTH 500 WEST
BOUNTIFUL UT
84010
US

V. Phone/Fax

Practice location:
  • Phone: 801-292-9355
  • Fax: 801-296-8050
Mailing address:
  • Phone: 801-292-9355
  • Fax: 801-296-8050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4828483-1202
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number272983-1202
License Number StateUT

VIII. Authorized Official

Name: DR. CORY M FROGLEY
Title or Position: OWNER
Credential: D.C
Phone: 801-292-9355