Provider Demographics
NPI:1932424058
Name:HOUGAARD CHIROPRACTIC
Entity Type:Organization
Organization Name:HOUGAARD CHIROPRACTIC
Other - Org Name:DRAPER CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:H
Authorized Official - Last Name:HOUGAARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-523-8700
Mailing Address - Street 1:11483 S STATE ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9403
Mailing Address - Country:US
Mailing Address - Phone:801-523-8700
Mailing Address - Fax:801-523-8191
Practice Address - Street 1:11483 S STATE ST
Practice Address - Street 2:SUITE F
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9403
Practice Address - Country:US
Practice Address - Phone:801-523-8700
Practice Address - Fax:801-523-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1764371202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty