Chiro-Active Inc.
Organization Active NPI Health Maintenance Organization · Hyde Park, UT
NPI 1639347677 · NPPES record last updated Mar 3, 2008
Key facts
- NPI
- 1639347677
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Maintenance Organization 302R00000X
- License
- 6859851-1202 (UT)
- Legal business name
- CHIRO-ACTIVE INC.
- Practice address
- 3935 N 75 W
Hyde Park, UT 84318-4111 - Phone
- (435) 563-4772
- NPI assigned
- Feb 12, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Justin Bruce Traveller, D.C.
- Title
- Owner
- Phone
- (435) 563-4772
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | 6859851-1202 | UT | Yes |
Addresses
Primary practice location
3935 N 75 W
Hyde Park, UT 84318-4111
Mailing address
3935 N 75 W
Hyde Park, UT 84318-4111
Phone (435) 563-4772
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6859851-1202 | Other | UT | LICENSE |
Other providers in Hyde Park, UT
- Cache Health
- Cameron G Peterson PC
- Erin Campbell
- Abbey Carlson
- Morgan Dee Carlson
- Melanie Christensen
- Cheryl Lynn Coleman
- Complete Fitness Innovations
- Melanie Elder
- Epic Eye Health PLLC
All providers in Hyde Park, UT · Health Maintenance Organization in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2008. 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.