Provider Demographics
NPI:1366864043
Name:CHIROPRACTIC HEALTH PLAN INC
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTH PLAN INC
Other - Org Name:CHP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:B
Authorized Official - Last Name:EGBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-641-9178
Mailing Address - Street 1:PO BOX 70097
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84170-0097
Mailing Address - Country:US
Mailing Address - Phone:801-352-7270
Mailing Address - Fax:801-352-7024
Practice Address - Street 1:7669 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-4007
Practice Address - Country:US
Practice Address - Phone:801-352-7270
Practice Address - Fax:801-352-7024
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLIED HEALTH SYSTEMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12443716003302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization