Provider Demographics
NPI:1801193842
Name:WARNER, TERAN (DC)
Entity Type:Individual
Prefix:
First Name:TERAN
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5069 W 13400 S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84096-6601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5069 W 13400 S
Practice Address - Street 2:SUITE 100
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84096-6601
Practice Address - Country:US
Practice Address - Phone:801-253-8141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-25
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7861490-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor