Provider Demographics
NPI:1851633796
Name:NEBEKER, COREY (DVM)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:
Last Name:NEBEKER
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8576 S REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-9313
Mailing Address - Country:US
Mailing Address - Phone:801-561-9595
Mailing Address - Fax:801-561-9607
Practice Address - Street 1:8576 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-9313
Practice Address - Country:US
Practice Address - Phone:801-561-9595
Practice Address - Fax:801-561-9607
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT116065-2801174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian