Provider Demographics
NPI:1952356305
Name:GUNNELL, JEFFREY TERRELL (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:TERRELL
Last Name:GUNNELL
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 1:289 E MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-2482
Mailing Address - Country:US
Mailing Address - Phone:801-766-4741
Mailing Address - Fax:801-766-8582
Practice Address - Street 1:289 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-2482
Practice Address - Country:US
Practice Address - Phone:801-766-4741
Practice Address - Fax:801-766-8582
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1149111N00000X
UT8758948-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT711482OtherOPTUM (UHC)
WAV04837Medicare UPIN
WA8852887Medicare ID - Type Unspecified