Provider Demographics
NPI:1285190587
Name:SPECTRUM CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:SPECTRUM CHIROPRACTIC, PLLC
Other - Org Name:VERO HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-901-8376
Mailing Address - Street 1:515 W 550 N STE B
Mailing Address - Street 2:
Mailing Address - City:LINDON
Mailing Address - State:UT
Mailing Address - Zip Code:84042-1348
Mailing Address - Country:US
Mailing Address - Phone:801-901-8376
Mailing Address - Fax:801-880-9565
Practice Address - Street 1:515 W 550 N STE B
Practice Address - Street 2:
Practice Address - City:LINDON
Practice Address - State:UT
Practice Address - Zip Code:84042-1348
Practice Address - Country:US
Practice Address - Phone:801-901-8376
Practice Address - Fax:801-880-9565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty