Healthcare Provider Details

I. General information

NPI: 1649704032
Provider Name (Legal Business Name): LAYTON CHIROPRACTIC & ACCIDENT REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

872 HERITAGE PARK BLVD SUITE 130
LAYTON UT
84041-5714
US

IV. Provider business mailing address

872 HERITAGE PARK BLVD SUITE 130
LAYTON UT
84041-5714
US

V. Phone/Fax

Practice location:
  • Phone: 801-784-7104
  • Fax:
Mailing address:
  • Phone: 801-784-7104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number8547239-1202
License Number StateUT

VIII. Authorized Official

Name: DR. RICHARD SARCHENKO
Title or Position: PHYSICIAN
Credential: D.C.
Phone: 801-784-7104