Provider Demographics
NPI:1265407282
Name:AMON, RICHARD P (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:AMON
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 1:3996 S 1900 W
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-3111
Mailing Address - Country:US
Mailing Address - Phone:801-731-2200
Mailing Address - Fax:801-731-2228
Practice Address - Street 1:3996 S 1900 W
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-3111
Practice Address - Country:US
Practice Address - Phone:801-731-2200
Practice Address - Fax:801-731-2228
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT171663-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor