Body Chiropractic PLLC
Chiropractor in Sandy, UT. Organization (NPI-2).
NPI number1124480280
StatusActive
Last updated in NPPESAug 15, 2023
Details
- NPI
- 1124480280
- Entity type
- Organization (NPI-2)
- Legal business name
- Body Chiropractic PLLC
- Organization subpart
- No
- Enumeration date
- Mar 27, 2016
- Certification date
- Aug 8, 2023
- Last updated
- Aug 15, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 9537864-1202 | UT | Yes |
Practice location
11075 S State St Ste 11bSandy, UT 84070-5190
Phone 801-871-5652 · Fax 888-505-5245
Mailing address
Po Box 95307South Jordan, UT 84095-0307
Phone 559-393-4225
Authorized official
Kristina Herrera Portillo
Owner
8018715652
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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