Provider Demographics
NPI:1790514784
Name:JUAB CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:JUAB CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DANE
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-698-4493
Mailing Address - Street 1:656 N MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:NEPHI
Mailing Address - State:UT
Mailing Address - Zip Code:84648-1123
Mailing Address - Country:US
Mailing Address - Phone:801-698-4493
Mailing Address - Fax:
Practice Address - Street 1:656 N MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:NEPHI
Practice Address - State:UT
Practice Address - Zip Code:84648-1123
Practice Address - Country:US
Practice Address - Phone:801-698-4493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty