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NPI Code Detail

MEDICARE: CAMPBELL CHIROPRACTIC CLINIC

MEDICARE: CAMPBELL CHIROPRACTIC CLINIC
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
1261QM2500XMedical Specialty Clinic/Center165972-1202UT

General Provider Information

NPI Number : 1619240561
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMPBELL CHIROPRACTIC CLINIC
Provider Business Mailing Address
First Line : 115 FORT UNION BLVD
Second Line :
City : MIDVALE
State : UT
Zip : 84047-1533
Country : US
Telephone Number : 801-566-4357
Fax Number : 801-566-4476
Provider Business Practice Location Address
First Line : 115 FORT UNION BLVD
Second Line :
City : MIDVALE
State : UT
Zip : 84047-1533
Country : US
Telephone Number : 801-566-4357
Fax Number : 801-566-4476
Authorized Official
Title or Position : MANAGER
Name : KAYLA LARSEN
Credential :
Telephone Number : 801-566-4357
Provider Enumeration Date : 02/22/2012
Last Update Date : 05/29/2019

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Directions to “CAMPBELL CHIROPRACTIC CLINIC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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