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General NPI Number Information
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NPI Number | 1295008589
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Entity Type | Organization
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Legal Business Name | SUMMIT VIEW HEALTH CENTER, LLC
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 1227 W 9000 S STE G
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City | WEST JORDAN
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State | UT
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Zip | 84088-9098
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Country | US
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Telephone | 801-748-0140
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Fax | 801-748-0141
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Provider Business Mailing Address
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Address Line | 1227 W 9000 S STE G
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City | WEST JORDAN
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State | UT
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Zip | 84088-9098
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Country | US
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Telephone | 801-748-0140
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Fax | 801-748-0141
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. JEFFERY GRAY
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Credential | DC
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Telephone | 801-748-0140
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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 | 4954621-1202
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License Number State | UT
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