Individual
THEODORE L. CONGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D. C.
Contact information
Practice address
747 E SOUTH TEMPLE STE 200, SALT LAKE CITY, UT 84102-1217
(801) 530-4802
Mailing address
747 E SOUTH TEMPLE STE 200, SALT LAKE CITY, UT 84102-1217
(801) 530-4802
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
171096-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107000433103
IHC HEALTH PLANS
UT
01
—
350011548
RR RETIREMENT
UT
01
—
4550443
AETNA
UT
01
—
TPRA10671
MOLINA HEALTHCARE
UT
Enumeration date
08/13/2006
Last updated
05/20/2020
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