Organization · NPI-2

Active Family Chiropractic INC

Chiropractor, Pediatric Chiropractor · Providence, UT

NPI number1255844239
StatusActive
Last updated in NPPESAug 4, 2022

Details

NPI
1255844239
Entity type
Organization (NPI-2)
Legal business name
Active Family Chiropractic INC
Organization subpart
No
Enumeration date
Nov 13, 2017
Certification date
Aug 4, 2022
Last updated
Aug 4, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111NP0017X Chiropractor, Pediatric Chiropractor––Yes
111N00000X Chiropractor65098601202UT

Other names

  • Active Family Chiropractic (Doing Business As)

Practice location

550 W 465 N Unit 502
Providence, UT 84332-8015

Phone 435-232-0732 · Fax 435-514-1814

Mailing address

550 W 465 N Unit 502
Providence, UT 84332-8015

Phone 435-232-0732 · Fax 435-514-1814

Authorized official

Stephanie A Hoglund
Owner
4352320732

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