Provider Demographics
NPI:1033489257
Name:DOC ROCK STONE CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:DOC ROCK STONE CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRL
Authorized Official - Middle Name:AMMON
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-785-0788
Mailing Address - Street 1:32 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-2630
Mailing Address - Country:US
Mailing Address - Phone:801-785-0788
Mailing Address - Fax:801-785-0922
Practice Address - Street 1:32 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2630
Practice Address - Country:US
Practice Address - Phone:801-785-0788
Practice Address - Fax:801-785-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000056074Medicare PIN