Provider Demographics
NPI:1518273226
Name:CHAMU, RUDI (DC)
Entity Type:Individual
Prefix:
First Name:RUDI
Middle Name:
Last Name:CHAMU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 W 13800 S
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-5373
Mailing Address - Country:US
Mailing Address - Phone:801-512-4638
Mailing Address - Fax:801-233-9051
Practice Address - Street 1:8541 S REDWOOD RD
Practice Address - Street 2:SUITE D
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-9327
Practice Address - Country:US
Practice Address - Phone:801-233-9050
Practice Address - Fax:801-233-9051
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7570323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor