Body Chiropractic Pllc | |
11075 S State St Ste 11b, Sandy, UT 84070-5190 | |
(801) 871-5652 | |
(888) 505-5245 |
Full Name | Body Chiropractic Pllc |
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Type | Facility |
Speciality | Chiropractor |
Location | 11075 S State St Ste 11b, Sandy, Utah |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1124480280 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 9537864-1202 (Utah) | Primary |
Provider Name | Kristina H Portillo |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1518335066 PECOS PAC ID: 6002103330 Enrollment ID: I20160929001454 |
Provider Name | Brett Anderson |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1528412582 PECOS PAC ID: 6800183104 Enrollment ID: I20160930001130 |
Mailing Address | Practice Location Address |
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Body Chiropractic Pllc Po Box 95307, South Jordan, UT 84095-0307 Ph: (559) 393-4225 | Body Chiropractic Pllc 11075 S State St Ste 11b, Sandy, UT 84070-5190 Ph: (801) 871-5652 |
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