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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