1538214523 NPI number — TRAN CHIROPRACTIC CLINC, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538214523 NPI number — TRAN CHIROPRACTIC CLINC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRAN CHIROPRACTIC CLINC, INC.
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:
HEALTHQUEST OF MURRAY
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:
1538214523
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32 W WINCHESTER ST
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
MURRAY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84107-5607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-281-0555
Provider Business Mailing Address Fax Number:
801-281-0444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32 W WINCHESTER ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
MURRAY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84107-5607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-281-0555
Provider Business Practice Location Address Fax Number:
801-281-0444
Provider Enumeration Date:
01/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NGUYEN
Authorized Official First Name:
JENNIE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
801-281-0555

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  275061-1202 , 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)

  • Identifier: 58634837900001 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




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