Provider Demographics
NPI:1265959886
Name:MUSCLE WORKS CHIROPRACTIC LLC
Entity type:Organization
Organization Name:MUSCLE WORKS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-995-8286
Mailing Address - Street 1:491 W BOURNE CIRCLE
Mailing Address - Street 2:BUILDING 2 SUITE #1
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025
Mailing Address - Country:US
Mailing Address - Phone:801-995-8286
Mailing Address - Fax:
Practice Address - Street 1:491 W BOURNE CIR STE 1
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-3650
Practice Address - Country:US
Practice Address - Phone:801-995-8286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8666873-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty