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General NPI Number Information
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NPI Number | 1548447063
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Entity Type | Organization
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Legal Business Name | ADVANCED CLINIC CHIROPRACTIC
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 7211 PLAZA CTR DR #120
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City | WEST JORDAN
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State | UT
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Zip | 84084-4317
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Country | US
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Telephone | 801-280-4629
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Fax | 801-280-8495
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Provider Business Mailing Address
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Address Line | 7211 PLAZA CTR DR #120
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City | WEST JORDAN
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State | UT
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Zip | 84084-4317
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Country | US
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Telephone | 801-280-4629
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Fax | 801-280-8495
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. JAMES A BROWN
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Credential | DC
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Telephone | 801-280-4629
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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 | 175690-1202
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License Number State |
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