MEDICARE: DR. STEVEN J CHALK D.C.

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	32444	CA

General Provider Information

NPI Number	:	1538412713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN J CHALK D.C.

Provider Business Mailing Address
First Line	:	4775 W DAYBREAK PKWY
Second Line	:	STE 102
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84009-5139
Country	:	US
Telephone Number	:	801-571-1338
Fax Number	:	801-516-4438

Provider Business Practice Location Address
First Line	:	4775 W DAYBREAK PKWY
Second Line	:	STE 102
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84009-5139
Country	:	US
Telephone Number	:	801-571-1338
Fax Number	:	801-516-4438

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2012
Last Update Date	:	12/14/2020

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