Provider Demographics
NPI:1811280670
Name:SIMPLY HEALTH CHIROPRACTIC CENTER PLLC
Entity type:Organization
Organization Name:SIMPLY HEALTH CHIROPRACTIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DURIEUX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:435-652-4395
Mailing Address - Street 1:1091 N BLUFF ST
Mailing Address - Street 2:SUITE# 309
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4894
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1091 N BLUFF ST
Practice Address - Street 2:SUITE# 309
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4894
Practice Address - Country:US
Practice Address - Phone:435-688-0444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7889602-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty