Provider Demographics
NPI:1558353979
Name:WERSLAND, KIRK R (DC)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:R
Last Name:WERSLAND
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 1:135 S 500 W
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8728
Mailing Address - Country:US
Mailing Address - Phone:801-292-9355
Mailing Address - Fax:801-296-8050
Practice Address - Street 1:135 S 500 W
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-8728
Practice Address - Country:US
Practice Address - Phone:801-292-9355
Practice Address - Fax:801-296-8050
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5201851-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U85790Medicare UPIN