Provider Demographics
NPI:1760601603
Name:GUTHRIE CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:GUTHRIE CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:GUTHRIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-957-9696
Mailing Address - Street 1:3856 W 5400 S
Mailing Address - Street 2:120
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84129-3579
Mailing Address - Country:US
Mailing Address - Phone:801-957-9696
Mailing Address - Fax:801-957-9694
Practice Address - Street 1:3856 W 5400 S
Practice Address - Street 2:120
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84129-3579
Practice Address - Country:US
Practice Address - Phone:801-957-9696
Practice Address - Fax:801-957-9694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT176424-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty