Organization
MISUSTIN CHIROPRACTIC PC
Active
Organization
MISUSTIN CHIROPRACTIC PC
Active
Other names
Peterson Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES LAWRENCE MISUSTIN D.C. (OWNER)
(435) 753-2840
Entity
Organization
Contact information
Practice address
1415 N 400 E, SUITE A, LOGAN, UT 84341-7539
(435) 753-2840
(435) 787-9422
Mailing address
1415 N 400 E, SUITE A, LOGAN, UT 84341-7539
(435) 753-2840
(435) 787-9422
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
320260-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
554155506001
—
UT
Enumeration date
12/28/2007
Last updated
02/27/2008
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