Provider Demographics
NPI:1073680526
Name:POSTURE ADVANTAGE LLC
Entity Type:Organization
Organization Name:POSTURE ADVANTAGE LLC
Other - Org Name:ACTIVE LIFE CHIROPRACTIC & MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-766-1256
Mailing Address - Street 1:785 E 200 S
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-2290
Mailing Address - Country:US
Mailing Address - Phone:801-766-1256
Mailing Address - Fax:801-766-9386
Practice Address - Street 1:785 E 200 S
Practice Address - Street 2:SUITE 4
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-2290
Practice Address - Country:US
Practice Address - Phone:801-766-1256
Practice Address - Fax:801-766-9386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6070595-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1720150717OtherNPI FOR DR. JAMES PARKER