Healthcare Provider Details

I. General information

NPI: 1487095634
Provider Name (Legal Business Name): DAWSON SPINAL CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2013
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11620 S STATE ST STE 1401
DRAPER UT
84020-7124
US

IV. Provider business mailing address

11620 S STATE ST STE 1401
DRAPER UT
84020-7124
US

V. Phone/Fax

Practice location:
  • Phone: 801-561-8000
  • Fax: 801-849-1868
Mailing address:
  • Phone: 801-561-8000
  • Fax: 801-849-1868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CRAIG RICHARD DAWSON
Title or Position: OWNER
Credential: D.C.
Phone: 801-561-8000