MEDICARE: LINFORD CHIROPRACTIC VACATION SERVICES

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
1	111N00000X	Chiropractor	6139191-1202	UT

General Provider Information

NPI Number	:	1164870804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINFORD CHIROPRACTIC VACATION SERVICES

Provider Business Mailing Address
First Line	:	6535 S WESTBROOK DR
Second Line	:
City	:	TAYLORSVILLE
State	:	UT
Zip	:	84129-6140
Country	:	US
Telephone Number	:	801-388-2101
Fax Number	:

Provider Business Practice Location Address
First Line	:	8822 S REDWOOD RD STE C212
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84088-5692
Country	:	US
Telephone Number	:	801-388-2101
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. JASON SCOTT LINFORD
Credential	:	DC
Telephone Number	:	801-388-2101

Provider Enumeration Date	:	06/02/2016
Last Update Date	:	04/11/2017

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