Healthcare Provider Details

I. General information

NPI: 1851592141
Provider Name (Legal Business Name): INTERMOUNTAIN CHIROPRACTIC AND SPORTS MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 E 800 N
SPANISH FORK UT
84660-1325
US

IV. Provider business mailing address

685 E 800 N
SPANISH FORK UT
84660-1325
US

V. Phone/Fax

Practice location:
  • Phone: 801-798-7746
  • Fax: 801-477-1572
Mailing address:
  • Phone: 801-798-7746
  • Fax: 801-477-1572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number5128490-1202
License Number StateUT

VIII. Authorized Official

Name: DR. VELOY K. COOK
Title or Position: OWNER
Credential: DC
Phone: 801-798-6558