Provider Demographics
NPI:1174665525
Name:CHIRO MAT CLINIC
Entity Type:Organization
Organization Name:CHIRO MAT CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BIOMECHANIC ENGINEER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:F
Authorized Official - Last Name:BUHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-544-2355
Mailing Address - Street 1:447 N 300 W
Mailing Address - Street 2:STE. #5
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-4203
Mailing Address - Country:US
Mailing Address - Phone:801-544-2355
Mailing Address - Fax:801-544-2358
Practice Address - Street 1:447 N 300 W
Practice Address - Street 2:STE. #5
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-4203
Practice Address - Country:US
Practice Address - Phone:801-544-2355
Practice Address - Fax:801-544-2358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1634321202305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization