Healthcare Provider Details

I. General information

NPI: 1760495808
Provider Name (Legal Business Name): MICAH LAWRENCE RIGBY D. C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N 570 E
TREMONTON UT
84337-6800
US

IV. Provider business mailing address

25 N 570 E
TREMONTON UT
84337-6800
US

V. Phone/Fax

Practice location:
  • Phone: 435-257-2131
  • Fax: 435-257-1349
Mailing address:
  • Phone: 435-257-2131
  • Fax: 435-257-1349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number289389-1202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: