{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "BODYWORKS CHIROPRACTIC CENTER INC",
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"Credential": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "1218 WEST SOUTH JORDAN PARKWAY",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "SOUTH JORDAN",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84095",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-302-0301",
"MailingAddressFaxNumber": "801-302-0311",
"FirstLinePracticeLocationAddress": "1218 WEST SOUTH JORDAN PARKWAY",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "SOUTH JORDAN",
"PracticeLocationAddressStateName": "UT",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "801-302-0301",
"PracticeLocationAddressFaxNumber": "801-302-0311",
"EnumerationDate": "02/13/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HALL",
"AuthorizedOfficialFirstName": "THERON",
"AuthorizedOfficialMiddleName": "B",
"AuthorizedOfficialTitle": "PRESIDENT OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "801-302-0301",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "3552091202",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}