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NPI Code Detail

MEDICARE: DR. ELLIS FRANCIS GORDON D.C.

MEDICARE:  DR. ELLIS FRANCIS GORDON  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
1111N00000XChiropractor362371-1202UT

General Provider Information

NPI Number : 1568685709
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELLIS FRANCIS GORDON D.C.
Provider Business Mailing Address
First Line : 2048 W 5400 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84118-1428
Country : US
Telephone Number : 801-968-5400
Fax Number : 801-968-5405
Provider Business Practice Location Address
First Line : 2048 W 5400 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84118-1428
Country : US
Telephone Number : 801-968-5400
Fax Number : 801-968-5405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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Directions to “ DR. ELLIS FRANCIS GORDON D.C.” Practice Location

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