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Organization

SOUTH OGDEN CHIROPRACTIC HEALTH

Active
Other names
Skyline Chiropractic
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JENNIFER BUNN (SECRATARY)
(801) 675-5600
Entity
Organization

Contact information

Practice address
2454 MONROE BLVD, OGDEN, UT 84401-2506
(801) 675-5600
(801) 605-3715
Mailing address
2454 MONROE BLVD, OGDEN, UT 84401-2506
(801) 675-5600
(801) 605-3715

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
287585-1202
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107012083102
SELECT HEALTH IHC
UT
01
197164
ALTIUS
UT
01
2238351
UNITED HEALTH CARE
UT
01
28758512000001
TADITIONAL BCBS
UT
01
28758512077001
NONTRAD BCBS
UT
05
505063944001
UT
Enumeration date
11/29/2006
Last updated
12/31/2012
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