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NPI Code Detail

MEDICARE: DR. ROMAN D. HENTISH D.C.

MEDICARE: DR. ROMAN D. HENTISH 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
1111NN1001XNutrition ChiropractorB01172NV
2111NR0400XRehabilitation Chiropractor5578639-1202UT

General Provider Information

NPI Number : 1821028861
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROMAN D. HENTISH D.C.
Provider Business Mailing Address
First Line : 8844 S 280 E
Second Line :
City : SANDY
State : UT
Zip : 84070-2343
Country : US
Telephone Number : 702-281-6847
Fax Number :
Provider Business Practice Location Address
First Line : 1972 W 5400 S
Second Line :
City : TAYLORSVILLE
State : UT
Zip : 84118-1459
Country : US
Telephone Number : 702-281-6847
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 02/17/2009

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Directions to “ DR. ROMAN D. HENTISH D.C.” Practice Location

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