Provider Demographics
NPI:1659576262
Name:WWH INC
Entity Type:Organization
Organization Name:WWH INC
Other - Org Name:ROY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:W
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HIRSBRUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-731-6800
Mailing Address - Street 1:1845 W. 4400 S.
Mailing Address - Street 2:STE. 104
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-3049
Mailing Address - Country:US
Mailing Address - Phone:801-731-6800
Mailing Address - Fax:801-731-6802
Practice Address - Street 1:1845 W. 4400 S.
Practice Address - Street 2:STE. 104
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-3049
Practice Address - Country:US
Practice Address - Phone:801-731-6800
Practice Address - Fax:801-731-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT166982-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT00005699Medicare ID - Type Unspecified