Healthcare Provider Details

I. General information

NPI: 1962871277
Provider Name (Legal Business Name): DR. ADAM TIMOTHY ARP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 S MAIN ST SUITE #3
PLEASANT GROVE UT
84062-2650
US

IV. Provider business mailing address

335 CEDARWOOD DR
OREM UT
84057-4108
US

V. Phone/Fax

Practice location:
  • Phone: 801-899-3904
  • Fax:
Mailing address:
  • Phone: 801-318-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5153374-1202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: