Organization
CANYON RIDGE CHIROPRACTIC, INC.
Active
Other names
Spine Brain Rehab, Utah Spine and Brain
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON LARRY SMITH DC, MS, DACNB (DOCTOR OF CHIROPRACTIC MEDICINE)
(801) 292-4400
Entity
Organization
Contact information
Practice address
520 MEDICAL DR STE 200, BOUNTIFUL, UT 84010-8928
(801) 292-4400
(844) 308-6615
Mailing address
520 MEDICAL DR STE 200, BOUNTIFUL, UT 84010-8928
(801) 292-4400
(844) 308-6615
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
369867-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427262195
NPI GROUP
UT
01
—
1558391169
INDIVIDUAL NPI
UT
01
—
52908255401001
BLUE CROSS BLUE SHIELD
UT
Enumeration date
05/10/2007
Last updated
12/06/2022
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