Organization
THEODORE L CONGER D.C., INC
Active
Other names
Conger Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE L CONGER D.C. (PHYSICIAN, PRESIDENT)
(801) 530-4802
Entity
Organization
Contact information
Practice address
747 E SOUTH TEMPLE STE 200, SALT LAKE CITY, UT 84102-1217
(801) 530-4802
(801) 530-0146
Mailing address
747 E SOUTH TEMPLE STE 200, SALT LAKE CITY, UT 84102-1217
(801) 530-4802
(801) 530-0146
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
171096-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4550443
AETNA
UT
05
—
534647011005
—
UT
Enumeration date
05/10/2007
Last updated
05/20/2020
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