Justin Chance Allen, DC
Individual provider Active NPI Chiropractor · Logan, UT
NPI 1255015186 · NPPES record last updated Jul 2, 2023
Key facts
- NPI
- 1255015186
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 13430079-1202 (UT)
- Practice address
- 265 S 400 E
Logan, UT 84321-5324 - Phone
- (435) 232-0566
- NPI assigned
- Jun 12, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13430079-1202 | UT | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mind, Body, Soul Chiropractic | Current |
Accepting new patients |
Locations
851 N Main St
Logan, UT 84321
Phone (435) 215-1775
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 13430079-1202 | UT | Yes |
Addresses
Primary practice location
265 S 400 E
Logan, UT 84321-5324
Mailing address
265 S 400 E
Logan, UT 84321-5324
Phone (435) 232-0566
Other practice location 1
851 N Main St
Logan, UT 84321-3228
Phone (435) 994-8599
Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.