Provider Demographics
NPI:1083861132
Name:SURREY, INC.
Entity Type:Organization
Organization Name:SURREY, INC.
Other - Org Name:STONE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-221-2599
Mailing Address - Street 1:1277 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2670
Mailing Address - Country:US
Mailing Address - Phone:801-221-2599
Mailing Address - Fax:801-765-1849
Practice Address - Street 1:1277 N STATE ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2670
Practice Address - Country:US
Practice Address - Phone:801-221-2599
Practice Address - Fax:801-765-1849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT278262-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000057349Medicare UPIN