Healthcare Provider Details

I. General information

NPI: 1679871859
Provider Name (Legal Business Name): SCOTT BINKERD DC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 05/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 E 5600 S
MURRAY UT
84107-6261
US

IV. Provider business mailing address

431 EAST 5600 SOUTH
MURRAY UT
84107
US

V. Phone/Fax

Practice location:
  • Phone: 801-262-2651
  • Fax: 801-262-2651
Mailing address:
  • Phone: 801-262-2651
  • Fax: 801-262-2651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1742761202
License Number StateUT

VIII. Authorized Official

Name: RAYMOND SCOTT BINKERD
Title or Position: CHIRORACTIC PHYSICIAN
Credential: DC
Phone: 801-262-2651