| Provo Sports And Family Chiropractic, Inc. | |
|
777 N 500 W Ste 205, Provo, UT 84601-1596 | |
| (801) 375-2420 | |
| (801) 374-8588 |
| Full Name | Provo Sports And Family Chiropractic, Inc. |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Sports Physician |
| Location | 777 N 500 W Ste 205, Provo, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003088402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NS0005X | Chiropractor - Sports Physician | 355063-1202 (Utah) | Primary |
| Provider Name | Eric James Brady |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1306934393 PECOS PAC ID: 5991797375 Enrollment ID: I20040402001285 |
| Provider Name | Austin Guy Blanchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144816661 PECOS PAC ID: 4385050848 Enrollment ID: I20210308001478 |
| Mailing Address | Practice Location Address |
|---|---|
| Provo Sports And Family Chiropractic, Inc. 777 N 500 W Ste 205, Provo, UT 84601-1596 Ph: (801) 375-2420 | Provo Sports And Family Chiropractic, Inc. 777 N 500 W Ste 205, Provo, UT 84601-1596 Ph: (801) 375-2420 |
Dr. Jeremiah Isaac Hernandez, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 2230 N. University Pkwy, Bldg 5, Ste A, Provo, UT 84604 Phone: 801-210-0669 | |
Dr. Gordon Mcclean, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 385 N 500 W, Provo, UT 84601 Phone: 801-373-1035 | |
Joshua James Redd, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 2230 N University Pkwy, 6b, Provo, UT 84604 Phone: 801-235-9944 | |
Nucca Spinal Centers Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 696 N 1890 W, Suite 43-a, Provo, UT 84601 Phone: 801-655-1801 Fax: 801-655-1803 | |
Jerry S Clark, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 3325 N University Ave Ste 125, Provo, UT 84604 Phone: 801-374-2774 Fax: 801-374-2775 | |
Performance Sport & Spine Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 2230 N University Pkwy Ste 6b, Provo, UT 84604 Phone: 801-235-9944 |