Provider Demographics
NPI:1689493405
Name:UPRIGHT CHIROPRACTIC LLC
Entity type:Organization
Organization Name:UPRIGHT CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-870-6894
Mailing Address - Street 1:841 S MANZANITA BLVD
Mailing Address - Street 2:
Mailing Address - City:DEWEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86327-7119
Mailing Address - Country:US
Mailing Address - Phone:208-870-6894
Mailing Address - Fax:
Practice Address - Street 1:13207 E STATE ROUTE 169 STE B
Practice Address - Street 2:
Practice Address - City:DEWEY
Practice Address - State:AZ
Practice Address - Zip Code:86327-0018
Practice Address - Country:US
Practice Address - Phone:928-499-0069
Practice Address - Fax:928-440-0780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty