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General NPI Number Information
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NPI Number | 1528365566
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Entity Type | Organization
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Legal Business Name | COPPERWELL CHIROPRACTIC LLC
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 5069 W 13400 S SUITE 100
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City | RIVERTON
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State | UT
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Zip | 84096-6601
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Country | US
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Telephone | 801-253-8141
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Fax | 801-253-2940
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Provider Business Mailing Address
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Address Line | 5069 W 13400 S SUITE 100
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City | RIVERTON
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State | UT
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Zip | 84096-6601
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Country | US
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Telephone | 801-253-8141
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Fax | 801-253-2940
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. TERAN WARNER
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Credential | D.C.
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Telephone | 801-253-8141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7861490-1202
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License Number State | UT
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