Provider Demographics
NPI:1821750183
Name:TVETEN, GABRIEL T (DC)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:T
Last Name:TVETEN
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 1:17 N MERCHANT ST STE 3
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-1601
Mailing Address - Country:US
Mailing Address - Phone:801-855-6101
Mailing Address - Fax:
Practice Address - Street 1:825 E 800 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-4244
Practice Address - Country:US
Practice Address - Phone:385-254-5552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2022-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12451468-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor