Healthcare Provider Details

I. General information

NPI: 1891889986
Provider Name (Legal Business Name): DAVID N BAILEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 E STATE ST
LEHI UT
84043-1656
US

IV. Provider business mailing address

680 E STATE ST
LEHI UT
84043-1656
US

V. Phone/Fax

Practice location:
  • Phone: 801-653-2800
  • Fax:
Mailing address:
  • Phone: 801-653-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number53083991202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: