Provider Demographics
NPI:1326487687
Name:INTEGRITY CHIROPRACTIC
Entity Type:Organization
Organization Name:INTEGRITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:W
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:435-213-9645
Mailing Address - Street 1:565 W 465 N
Mailing Address - Street 2:SUITE 140
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-4801
Mailing Address - Country:US
Mailing Address - Phone:433-213-9645
Mailing Address - Fax:
Practice Address - Street 1:565 W 465 N
Practice Address - Street 2:SUITE 140
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-4801
Practice Address - Country:US
Practice Address - Phone:433-213-9645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8449495-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty