Organization
CHIROPRACTIC AVENUE LLC
Active
Other names
Balanced Spinal Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT DAVID NOORDA D.C. (MANAGING PARTNER)
(435) 688-2292
Entity
Organization
Contact information
Practice address
169 W 2710 SOUTH CIR, SUITE 204, ST GEORGE, UT 84790-7201
(435) 688-2292
Mailing address
3155 S HIDDEN VALLEY DR, UNIT 175, ST. GEORGE, UT 84790
(435) 688-2292
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
7443716-1202
UT
Other
Enumeration date
11/09/2010
Last updated
02/16/2011
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