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General NPI Number Information
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NPI Number | 1003831223
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Entity Type | Individual
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Provider Name | DAN EGBERT D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1273 W 12600 S STE 401
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City | RIVERTON
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State | UT
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Zip | 84065-7111
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Country | US
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Telephone | 801-446-0383
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Fax | 801-446-0391
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Provider Business Mailing Address
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Address Line | 1273 W 12600 S STE 401 P.O. BOX 949
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City | RIVERTON
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State | UT
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Zip | 84065-7111
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Country | US
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Telephone | 801-446-0383
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Fax | 801-446-0391
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 292680-1202
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License Number State | UT
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