Provider Demographics
NPI:1013021468
Name:BODY RIGHT CHIORPRACTIC INC
Entity Type:Organization
Organization Name:BODY RIGHT CHIORPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-614-0166
Mailing Address - Street 1:2179 W 1800 N STE C2
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:UT
Mailing Address - Zip Code:84015-7900
Mailing Address - Country:US
Mailing Address - Phone:801-614-0166
Mailing Address - Fax:801-614-0167
Practice Address - Street 1:2179 W 1800 N STE C2
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:UT
Practice Address - Zip Code:84015-7900
Practice Address - Country:US
Practice Address - Phone:801-614-0166
Practice Address - Fax:801-614-0167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5188221-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT51882211203001OtherBCBS OF UTAH
UT000056330Medicare PIN