Provider Demographics
NPI:1871670232
Name:HOUR, RAYMOND RATTANA (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:RATTANA
Last Name:HOUR
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 1:11582 COUNTRY CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-8038
Mailing Address - Country:US
Mailing Address - Phone:801-972-2162
Mailing Address - Fax:801-972-3473
Practice Address - Street 1:3534 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-3819
Practice Address - Country:US
Practice Address - Phone:801-972-2162
Practice Address - Fax:801-972-3473
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT345668-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U66975Medicare UPIN