Provider Demographics
NPI:1528003688
Name:MECHAM, ALLAN L (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:L
Last Name:MECHAM
Suffix:
Gender:M
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:PO BOX 150321
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84415-0321
Mailing Address - Country:US
Mailing Address - Phone:801-475-1800
Mailing Address - Fax:801-475-0071
Practice Address - Street 1:1186 E 4600 S
Practice Address - Street 2:SUITE 220
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4332
Practice Address - Country:US
Practice Address - Phone:801-475-1800
Practice Address - Fax:801-475-0071
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT334874-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU69486Medicare UPIN