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NPI Code Detail

MEDICARE: NORMAN CHIROPRACTIC CLINIC, LLC

MEDICARE: NORMAN CHIROPRACTIC CLINIC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor272296-1202UT

General Provider Information

NPI Number : 1114226594
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORMAN CHIROPRACTIC CLINIC, LLC
Provider Business Mailing Address
First Line : 880 HERITAGE PARK BLVD STE 130
Second Line :
City : LAYTON
State : UT
Zip : 84041-5674
Country : US
Telephone Number : 801-678-0390
Fax Number :
Provider Business Practice Location Address
First Line : 880 HERITAGE PARK BLVD STE 130
Second Line :
City : LAYTON
State : UT
Zip : 84041-5674
Country : US
Telephone Number : 801-678-0390
Fax Number :
Authorized Official
Title or Position : OWNER/CHIROPRACTOR
Name : DR. JEFFERY GLENN NORMAN
Credential : DC
Telephone Number : 801-678-0390
Provider Enumeration Date : 03/24/2011
Last Update Date : 03/24/2011

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