Provider Demographics
NPI:1629716824
Name:CARLI, KADEN
Entity Type:Individual
Prefix:
First Name:KADEN
Middle Name:
Last Name:CARLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3856 N NEWLAND LOOP UNIT 5
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4917
Mailing Address - Country:US
Mailing Address - Phone:801-860-3342
Mailing Address - Fax:
Practice Address - Street 1:3856 N NEWLAND LOOP UNIT 5
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-4917
Practice Address - Country:US
Practice Address - Phone:801-860-3342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11351634-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty