Healthcare Provider Details

I. General information

NPI: 1427243849
Provider Name (Legal Business Name): CLAYTON CHIROPRACTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 26TH ST SUITE 101
OGDEN UT
84401-2465
US

IV. Provider business mailing address

533 26TH ST SUITE 101
OGDEN UT
84401-2459
US

V. Phone/Fax

Practice location:
  • Phone: 801-621-1668
  • Fax: 801-621-1670
Mailing address:
  • Phone: 801-621-1668
  • Fax: 801-621-1670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number169368-1202
License Number StateUT

VIII. Authorized Official

Name: DR. FRANK J. CLAYTON
Title or Position: OWNER/DOCTOR
Credential: D.C.
Phone: 801-621-1668