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Organization
CACHE VALLEY CHIROPRACTIC CLINIC LLC
Active
Organization
CACHE VALLEY CHIROPRACTIC CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEIL LOUIS ERICKSON DC (OWNER)
(435) 752-2772
Entity
Organization
Contact information
Practice address
169 N GATEWAY DR STE 223, PROVIDENCE, UT 84332-9856
(435) 752-2772
(435) 752-2878
Mailing address
169 N GATEWAY DR STE 223, PROVIDENCE, UT 84332-9856
(435) 752-7722
(435) 752-2878
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
169476-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10294
ALTIUS
UT
01
—
22321
PEHP
UT
05
—
519720002009
—
UT
01
—
870395551ER1
EMIA
UT
01
—
94287113577001
BLUE CROSS BLUE SHIELD
UT
Enumeration date
01/31/2007
Last updated
05/20/2020
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