Organization
BEN LOMOND CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN G TANNER D.C. (MEMBER)
(801) 782-0987
Entity
Organization
Contact information
Practice address
428 E 2600 N, STE #5, NORTH OGDEN, UT 84414
(801) 782-0987
(801) 782-7518
Mailing address
428 E 2600 N, STE #5, NORTH OGDEN, UT 84414
(801) 782-0987
(801) 782-7518
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5960456-1202
UT
111N00000X
Chiropractor
6929478-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528651166001
—
UT
01
—
59604561200001
BLUE CROSS
UT
Enumeration date
06/14/2018
Last updated
06/14/2018
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