Provider Demographics
NPI:1508192311
Name:GLASGOW, KIMBERLY KERCHER (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:KERCHER
Last Name:GLASGOW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:JEAN
Other - Last Name:KERCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:866 E 12300 S STE C
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-5018
Mailing Address - Country:US
Mailing Address - Phone:801-810-4144
Mailing Address - Fax:
Practice Address - Street 1:12397 S 300 E STE 200
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8274
Practice Address - Country:US
Practice Address - Phone:801-758-0225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7464186-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor