Provider Demographics
NPI:1649515982
Name:MY FAMILY CHIRO, LLC
Entity type:Organization
Organization Name:MY FAMILY CHIRO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:435-703-9406
Mailing Address - Street 1:249 E TABERNACLE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-2995
Mailing Address - Country:US
Mailing Address - Phone:435-703-9410
Mailing Address - Fax:435-703-9406
Practice Address - Street 1:249 E TABERNACLE ST STE 300
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2995
Practice Address - Country:US
Practice Address - Phone:435-703-9410
Practice Address - Fax:435-703-9406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8272326-1202261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center