Provider Demographics
NPI:1063006104
Name:FOUNDATION CHIROPRACTIC OF LEHI
Entity Type:Organization
Organization Name:FOUNDATION CHIROPRACTIC OF LEHI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFRY
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-226-2606
Mailing Address - Street 1:628 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-1677
Mailing Address - Country:US
Mailing Address - Phone:801-766-1366
Mailing Address - Fax:801-607-6999
Practice Address - Street 1:628 E STATE ST
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-1677
Practice Address - Country:US
Practice Address - Phone:801-766-1366
Practice Address - Fax:801-607-6999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty