Provider Demographics
NPI:1700922481
Name:STONE, SHIRL AMMON (DC)
Entity Type:Individual
Prefix:DR
First Name:SHIRL
Middle Name:AMMON
Last Name:STONE
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 1:1042 E BAMBERGER DR
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-5504
Mailing Address - Country:US
Mailing Address - Phone:801-794-9494
Mailing Address - Fax:801-785-0788
Practice Address - Street 1:1042 E BAMBERGER DR
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-5504
Practice Address - Country:US
Practice Address - Phone:801-794-9494
Practice Address - Fax:801-785-0788
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT278283-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000056074Medicare ID - Type UnspecifiedMEDICARE ID
UT350054385Medicare ID - Type UnspecifiedRAILROAD MEDICARE ID