=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356255996
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RENNIE FAMILY CHIROPRACTIC PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2026
-----------------------------------------------------
Last Update Date | 09/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 N MAIN ST
-----------------------------------------------------
City | SPANISH FORK
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84660-1726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 385-257-3857
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 181 E 560 N
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84653-5711
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-375-5130
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CAMERON S RENNIE
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 508-375-5130
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------