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Individual

LILLIAN NICOLE FACKRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
6717 S 900 E STE 101, MIDVALE, UT 84047-5755
(801) 784-8886
Mailing address
190 S TAMARAK CIR, LEHI, UT 84043-2761
(816) 419-6513

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
13763325
UT
111N00000X
Chiropractor
Primary
13763325-1202
UT

Other

Enumeration date
02/22/2024
Last updated
08/27/2024
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