Provider Demographics
NPI:1831255033
Name:HARDY, BRIAN NEIL (DC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:NEIL
Last Name:HARDY
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 1:1173 S 250 W
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-6392
Mailing Address - Country:US
Mailing Address - Phone:435-688-8830
Mailing Address - Fax:
Practice Address - Street 1:1173 S 250 W
Practice Address - Street 2:SUITE 108
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-6392
Practice Address - Country:US
Practice Address - Phone:435-688-8830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4975198-1202111N00000X
UT4975198-1201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist