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General NPI Number Information
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NPI Number | 1285173294
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Entity Type | Organization
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Legal Business Name | ALIGNMENT AND PERFORMANCE CENTER OF UTAH, PLLC
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Dates
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Enumeration Date | 02/23/2017
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 912 N 2000 W
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-4047
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Country | US
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Telephone | 801-756-2861
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Fax | 801-492-1882
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Provider Business Mailing Address
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Address Line | 912 N 2000 W
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-4047
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Country | US
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Telephone | 801-756-2861
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Fax | 801-492-1882
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY RUSSELL ARBUCKLE JR.
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Credential | DC
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Telephone | 610-952-2172
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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 | 10137197-1202
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License Number State | UT
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