Provider Demographics
NPI:1598894685
Name:ADAMS, ALAN JOHN (DC)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:JOHN
Last Name:ADAMS
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 1:7555 CENTER VIEW CT
Mailing Address - Street 2:#102
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-1970
Mailing Address - Country:US
Mailing Address - Phone:801-568-9222
Mailing Address - Fax:801-568-9559
Practice Address - Street 1:7555 CENTER VIEW CT
Practice Address - Street 2:#102
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-1970
Practice Address - Country:US
Practice Address - Phone:801-568-9222
Practice Address - Fax:801-568-9559
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3355291202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU70680Medicare UPIN