=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306168208
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BARRUS CHIROPRACTIC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2010
-----------------------------------------------------
Last Update Date | 02/18/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 894 N 2000 W
-----------------------------------------------------
City | PLEASANT GROVE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84062-4047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-756-2861
-----------------------------------------------------
Fax | 801-492-1882
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 894 N 2000 W
-----------------------------------------------------
City | PLEASANT GROVE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84062-4047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-756-2861
-----------------------------------------------------
Fax | 801-492-1882
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. JAMES SCOTT BARRUS
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 801-756-2861
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 319260-1202
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------