Organization
GENESIS CHIROPRACTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANI T FRIES D.C. (PRESIDENT)
(801) 485-2580
Entity
Organization
Contact information
Practice address
1200 E 3300 S, SALT LAKE CITY, UT 84106-2522
(801) 485-2580
(801) 485-2587
Mailing address
1200 E 3300 S, SALT LAKE CITY, UT 84106-2522
(801) 485-2580
(801) 485-2587
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5005891-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
624033371001
—
UT
Enumeration date
04/05/2012
Last updated
04/05/2012
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