Individual
MARK SWAIN ALDRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3300 RUNNING CREEK WAY, BLD E STE 200, LEHI, UT 84043-5563
(801) 766-2080
(801) 766-4776
Mailing address
3300 RUNNING CREEK WAY, BLD E STE 200, LEHI, UT 84043-5563
(801) 766-2080
(801) 766-4776
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
0104555765
VA
111N00000X
Chiropractor
Primary
328280-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32-0003223
EMPLOYER IDENTIFICATION
VA
01
—
453363
ANTHEM PROVIDER NUMBER
VA
Enumeration date
01/30/2007
Last updated
01/06/2010
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