Provider Demographics
NPI:1134422306
Name:CHENEY, ERIC LEE (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:LEE
Last Name:CHENEY
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 1:44 W 7200 S
Mailing Address - Street 2:STE. B
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-3751
Mailing Address - Country:US
Mailing Address - Phone:801-259-3308
Mailing Address - Fax:
Practice Address - Street 1:44 W 7200 S
Practice Address - Street 2:STE. B
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-3751
Practice Address - Country:US
Practice Address - Phone:801-259-3308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7825506-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor