Healthcare Provider Details

I. General information

NPI: 1063343374
Provider Name (Legal Business Name): BAKER FAMILY CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1054 E RIVERSIDE DR STE 202
ST GEORGE UT
84790-4829
US

IV. Provider business mailing address

1054 E RIVERSIDE DR STE 202
ST GEORGE UT
84790-4829
US

V. Phone/Fax

Practice location:
  • Phone: 435-414-0330
  • Fax: 435-359-5102
Mailing address:
  • Phone: 435-414-0330
  • Fax: 435-359-5102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. TYLER BAKER
Title or Position: CHIROPRACTOR/OWNER
Credential: DC
Phone: 435-414-0330