Organization
STATERA CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS GREGORY DC (OWNER)
(385) 288-0934
Entity
Organization
Contact information
Practice address
736 W RIVERDALE ROAD, RIVERDALE, UT 84405
(385) 288-0934
Mailing address
736 W RIVERDALE ROAD, RIVERDALE, UT 84405
(385) 288-0934
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
10638431-1202
UT
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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