| NPI | 1184118028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN G TANNER Member 801-782-0987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: UT 5960456-1202) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: UT 6929478-1202) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2018-06-14 |