Provider Demographics
NPI:1790844678
Name:O'BRYANT, CHRIS A (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:A
Last Name:O'BRYANT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6313 IMPERIAL OAK DR
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-1872
Mailing Address - Country:US
Mailing Address - Phone:801-898-3147
Mailing Address - Fax:801-487-0109
Practice Address - Street 1:2020 E 3300 S
Practice Address - Street 2:SUITE 16
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-2677
Practice Address - Country:US
Practice Address - Phone:801-487-4999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4827298-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU82831Medicare UPIN