Provider Demographics
NPI:1669444303
Name:VOSTI, MARK V (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:V
Last Name:VOSTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:392 E 12300 S
Mailing Address - Street 2:STE C
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8043
Mailing Address - Country:US
Mailing Address - Phone:801-619-6090
Mailing Address - Fax:801-553-6323
Practice Address - Street 1:1101 DRAPER PKWY
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9096
Practice Address - Country:US
Practice Address - Phone:801-619-6090
Practice Address - Fax:801-553-6323
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2774298-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor