Healthcare Provider Details
I. General information
NPI: 1982918033
Provider Name (Legal Business Name): OAKWOOD CHIROPRACTIC OFFICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2010
Last Update Date: 07/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7086 HIGHLAND DR SUITE 50
COTTONWOOD HEIGHTS UT
84121-3766
US
IV. Provider business mailing address
7086 HIGHLAND DR SUITE 50
COTTONWOOD HEIGHTS UT
84121-3766
US
V. Phone/Fax
- Phone: 801-943-3355
- Fax:
- Phone: 801-943-3355
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 262577-1202 |
| License Number State | UT |
VIII. Authorized Official
Name: DR.
STUART
JOHN
YEAGER
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 801-943-3355