Provider Demographics
NPI:1033302930
Name:WORKMAN CHIROPRACTIC CLINIC D.C. P.C.
Entity Type:Organization
Organization Name:WORKMAN CHIROPRACTIC CLINIC D.C. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:435-865-9556
Mailing Address - Street 1:415 N MAIN ST
Mailing Address - Street 2:STE 207
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-2623
Mailing Address - Country:US
Mailing Address - Phone:435-865-9556
Mailing Address - Fax:435-865-9570
Practice Address - Street 1:415 N MAIN ST
Practice Address - Street 2:STE 207
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2623
Practice Address - Country:US
Practice Address - Phone:435-865-9556
Practice Address - Fax:435-865-9570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4782653-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1821135583OtherNPI
UTU81836Medicare UPIN