MEDICARE: CHIROPRACTIC ASSOCIATES INC

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	1527571202	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558545616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC ASSOCIATES INC

Provider Business Mailing Address
First Line	:	7669 S REDWOOD RD
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84084-4007
Country	:	US
Telephone Number	:	801-566-2465
Fax Number	:	801-566-0247

Provider Business Practice Location Address
First Line	:	7669 S REDWOOD RD
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84084-4007
Country	:	US
Telephone Number	:	801-566-2465
Fax Number	:	801-566-0247

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	DR. HAROLD W GUNN JR.
Credential	:	D.C.
Telephone Number	:	801-566-2465

Provider Enumeration Date	:	12/26/2007
Last Update Date	:	01/15/2008

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