Provider Demographics
NPI:1245307701
Name:ALLRED, BRANDON K (DC)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:K
Last Name:ALLRED
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 1:7840 S 700 E
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-0278
Mailing Address - Country:US
Mailing Address - Phone:801-256-0006
Mailing Address - Fax:801-256-0005
Practice Address - Street 1:7840 S 700 E
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-0278
Practice Address - Country:US
Practice Address - Phone:801-256-0006
Practice Address - Fax:801-256-0005
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3690811202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor