1265604219 NPI number — HARPER ROCKY MOUNTAIN CHIROPRACTIC, PC

Table of content: (NPI 1265604219)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265604219 NPI number — HARPER ROCKY MOUNTAIN CHIROPRACTIC, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARPER ROCKY MOUNTAIN CHIROPRACTIC, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ADVANCED HEALTH CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265604219
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2363 N HILL FIELD RD STE 7
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAYTON
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84041-6958
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-416-8247
Provider Business Mailing Address Fax Number:
801-416-8248

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2363 N HILL FIELD RD
Provider Second Line Business Practice Location Address:
SUITE #7
Provider Business Practice Location Address City Name:
LAYTON
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84041-6909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-416-8247
Provider Business Practice Location Address Fax Number:
801-416-8248
Provider Enumeration Date:
03/31/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HARPER
Authorized Official First Name:
LEWIS
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
801-416-8247

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  349190-1202 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com