| Wasatch Sports And Family Chiropractic Pllc | |
|
230 N 1200 E, 102, Lehi, UT 84043-5865 | |
| (940) 453-7602 | |
| Not Available |
| Full Name | Wasatch Sports And Family Chiropractic Pllc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 230 N 1200 E, Lehi, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881094431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 6374884-1202 (Utah) | Primary |
| Provider Name | Courtney Johnson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1336549922 PECOS PAC ID: 4789806233 Enrollment ID: I20141120001814 |
| Mailing Address | Practice Location Address |
|---|---|
| Wasatch Sports And Family Chiropractic Pllc 5442 W 10030 N, Highland, UT 84003-9170 Ph: (940) 453-7602 | Wasatch Sports And Family Chiropractic Pllc 230 N 1200 E, 102, Lehi, UT 84043-5865 Ph: (940) 453-7602 |
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