Provider Demographics
NPI:1326432766
Name:CAPSTONE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CAPSTONE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-272-8500
Mailing Address - Street 1:2200 E 4500 S
Mailing Address - Street 2:STE 110
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-4437
Mailing Address - Country:US
Mailing Address - Phone:801-272-8500
Mailing Address - Fax:801-272-3562
Practice Address - Street 1:2200 E 4500 S
Practice Address - Street 2:STE 110
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-4437
Practice Address - Country:US
Practice Address - Phone:801-272-8500
Practice Address - Fax:801-272-3562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9246735-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty