Organization
RENEGADE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAYLOR DIETZ DC (OWNER)
(801) 769-6570
Entity
Organization
Contact information
Practice address
1028 WEST 950 N, SUITE 103, OREM, UT 85047
(801) 769-6570
Mailing address
1028 WEST 950 N, SUITE 103, OREM, UT 85047
(801) 769-6570
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
07/23/2021
Last updated
08/20/2021
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