Provider Demographics
NPI:1285838524
Name:MAPLE RIDGE HEALTH SYSTEMS
Entity Type:Organization
Organization Name:MAPLE RIDGE HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TEMPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-571-7670
Mailing Address - Street 1:11483 SOUTH STATE ST.
Mailing Address - Street 2:SUITE F
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020
Mailing Address - Country:US
Mailing Address - Phone:801-571-7670
Mailing Address - Fax:801-571-7674
Practice Address - Street 1:11483 SOUTH STATE ST.
Practice Address - Street 2:SUITE F
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020
Practice Address - Country:US
Practice Address - Phone:801-571-7670
Practice Address - Fax:801-571-7674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty