Individual
DAVID KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O., D.C.
Contact information
Practice address
3000 N TRIUMPH BLVD STE 100, LEHI, UT 84043-4999
(801) 203-1215
(801) 766-5792
Mailing address
1055 N 500 W ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
7111227-1202
UT
207Q00000X
Family Medicine Physician
Primary
7111227-1204
UT
207Q00000X
Family Medicine Physician
MRO-1496
ID
Other
Enumeration date
01/07/2009
Last updated
05/10/2018
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