Healthcare Provider Details

I. General information

NPI: 1912817289
Provider Name (Legal Business Name): CAMERON RENNIE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 E 800 N
SPANISH FORK UT
84660-1325
US

IV. Provider business mailing address

181 E 560 N
SALEM UT
84653-5711
US

V. Phone/Fax

Practice location:
  • Phone: 508-375-5130
  • Fax:
Mailing address:
  • Phone: 508-375-5130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number14308512-1202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: