Provider Demographics
NPI:1740581636
Name:BABCOCK, BRENT EUGENE (BRENT BABCOCK)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:EUGENE
Last Name:BABCOCK
Suffix:
Gender:M
Credentials:BRENT BABCOCK
Other - Prefix:
Other - First Name:BRENT
Other - Middle Name:EUGENE
Other - Last Name:BABCOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BRENT BABCOCK, DC
Mailing Address - Street 1:1397 W SUNSET BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4212
Mailing Address - Country:US
Mailing Address - Phone:435-275-8888
Mailing Address - Fax:435-275-9230
Practice Address - Street 1:1397 W SUNSET BLVD STE 109
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4212
Practice Address - Country:US
Practice Address - Phone:435-275-8888
Practice Address - Fax:435-275-9230
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13220220-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor