Provider Demographics
NPI:1629257175
Name:SENIOR HEALTHLYNK
Entity Type:Organization
Organization Name:SENIOR HEALTHLYNK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:435-688-1415
Mailing Address - Street 1:PO BOX 911386
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84791-1386
Mailing Address - Country:US
Mailing Address - Phone:435-688-1415
Mailing Address - Fax:435-688-1204
Practice Address - Street 1:1495 S BLACK RIDGE DR
Practice Address - Street 2:STE A 210
Practice Address - City:ST. GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770
Practice Address - Country:US
Practice Address - Phone:435-688-1415
Practice Address - Fax:435-688-1204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2774757-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty