Pack Chiropractic Clinic, Inc

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

1305 Issued in OH

Legal business name

PACK CHIROPRACTIC CLINIC, INC

Practice address

2565 Tyler Ave
Ogden, UT 84401-2818

Phone

(801) 245-9010

NPI assigned

Jan 5, 2012

Last updated

Feb 8, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Pack, DC

Title

President

Phone

(801) 245-9010

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1659641827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 TYLER AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844012818",
            "telephone_number": "801-245-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 TYLER AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844012818",
            "telephone_number": "801-245-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACK CHIROPRACTIC CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-05",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-245-9010",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "OH",
            "license": "1305",
            "primary": true
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "OH",
            "license": "1305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Oyler
• Jade Lani Ozawa
• Yuta Ozawa
• Patrice Ozuna
• Bobette W Pace, LCSW
• Erin L Packer, RN
• Grace Packer
• Mark D Packer, MD
• Rafael Nicolas Padilla, MPT
• McKenzie Padovich

• Sports Physician Chiropractor in Ogden, UT
• Providers in Ogden, UT by specialty
• Sports Physician Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.