Provider Demographics
NPI:1326226788
Name:DAVIS COUNTY SPINAL CARE, PC
Entity Type:Organization
Organization Name:DAVIS COUNTY SPINAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:L
Authorized Official - Middle Name:BRYCE
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-294-6333
Mailing Address - Street 1:PO BOX 613
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014
Mailing Address - Country:US
Mailing Address - Phone:801-294-6333
Mailing Address - Fax:801-294-8005
Practice Address - Street 1:1134 W 500 N
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84014-1721
Practice Address - Country:US
Practice Address - Phone:801-294-6333
Practice Address - Fax:801-294-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT317180-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty