Provider Demographics
NPI:1629136445
Name:ROSENTHAL, DAVID M (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:ROSENTHAL
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 1:792 S 400 E
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-6322
Mailing Address - Country:US
Mailing Address - Phone:801-372-5141
Mailing Address - Fax:801-226-3383
Practice Address - Street 1:792 S 400 E
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-6322
Practice Address - Country:US
Practice Address - Phone:801-372-5141
Practice Address - Fax:801-226-3383
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT338627-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor