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General NPI Number Information
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NPI Number | 1851548283
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Entity Type | Organization
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Legal Business Name | GALEN C. BIRDSLEY P.C.
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 1360 S MAIN ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-5336
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Country | US
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Telephone | 801-467-7141
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Fax | 801-467-7246
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Provider Business Mailing Address
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Address Line | 1360 S MAIN ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-5336
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Country | US
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Telephone | 801-467-7141
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Fax | 801-467-7246
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Authorized Official
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Title or Position | CHIROPRACTOR/PRESIDENT
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Name | DR. GALEN C BIRDSLEY
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Credential | D.C.
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Telephone | 801-467-7141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1618131202
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License Number State | UT
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