Provider Demographics
NPI:1538108782
Name:BREY, ALVIN LEON (DC)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:LEON
Last Name:BREY
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 1:13121 S REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-6102
Mailing Address - Country:US
Mailing Address - Phone:801-254-1048
Mailing Address - Fax:
Practice Address - Street 1:9386 REDWOOD RD
Practice Address - Street 2:STE C
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-6513
Practice Address - Country:US
Practice Address - Phone:801-748-1830
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT169354-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor