Healthcare Provider Details

I. General information

NPI: 1265522379
Provider Name (Legal Business Name): ROBERT KENNETH WHEELER II D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 N 1120 W
PROVO UT
84604-1180
US

IV. Provider business mailing address

1807 N 1120 W
PROVO UT
84604-1180
US

V. Phone/Fax

Practice location:
  • Phone: 385-442-2225
  • Fax: 385-442-2226
Mailing address:
  • Phone: 385-442-2225
  • Fax: 385-442-2226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number341
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: