MEDICARE: DR. CHRIS KESLER 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	169904-1202	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	36408	OTHER	UT	DMBA
2	870395551KE3	OTHER	UT	EDUCATORS MUTUAL
3	51799	OTHER	UT	UUHP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	19954	OTHER	UT	PEHP
6	QM0000010539	OTHER	UT	ALTIUS

General Provider Information

NPI Number	:	1720103435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRIS KESLER D.C.

Provider Business Mailing Address
First Line	:	1760 E FORT UNION BLVD
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-2852
Country	:	US
Telephone Number	:	801-942-7272
Fax Number	:	801-942-7287

Provider Business Practice Location Address
First Line	:	1760 E FORT UNION BLVD
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-2852
Country	:	US
Telephone Number	:	801-942-7272
Fax Number	:	801-942-7287

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	02/28/2017

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