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NPI Code Detail

MEDICARE: DR. CHRIS A. O'BRYANT DC

MEDICARE: DR. CHRIS A. O'BRYANT DC
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
1111N00000XChiropractor4827298-1202UT

General Provider Information

NPI Number : 1790844678
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRIS A. O'BRYANT DC
Provider Business Mailing Address
First Line : 6313 IMPERIAL OAK DR
Second Line :
City : WEST JORDAN
State : UT
Zip : 84088-1872
Country : US
Telephone Number : 801-898-3147
Fax Number : 801-487-0109
Provider Business Practice Location Address
First Line : 2020 E 3300 S
Second Line : SUITE 16
City : SALT LAKE CITY
State : UT
Zip : 84109-2677
Country : US
Telephone Number : 801-487-4999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2006
Last Update Date : 07/08/2007

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