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General NPI Number Information
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NPI Number | 1871893172
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Entity Type | Organization
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Legal Business Name | BRIGHAM CITY CHIROPRACTIC & ACCIDENT REHABILITATION
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 75 E 600 S
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City | BRIGHAM CITY
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State | UT
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Zip | 84302-3227
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Country | US
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Telephone | 435-734-2095
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Fax |
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Provider Business Mailing Address
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Address Line | 1264 N 500 W
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City | OREM
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State | UT
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Zip | 84057-2929
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Country | US
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Telephone | 801-400-5043
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. STEVE A BAKER
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Credential | DC
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Telephone | 801-400-5043
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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 |
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License Number State |
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