| Dudley Chiropractic & Wellness Center Lc | |
|
1053 E 2100 S Salt Lake City UT 84106 | |
| (801) 359-3995 | |
| (801) 359-8489 |
| Full Name | Dudley Chiropractic & Wellness Center Lc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1053 E 2100 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Mark Dudley (OWNER) |
| Authorized Official Contact | 8013593995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dudley Chiropractic & Wellness Center Lc 1053 E 2100 S Salt Lake City UT 84106-2349 Ph: (801) 359-3995 | Dudley Chiropractic & Wellness Center Lc 1053 E 2100 S Salt Lake City UT 84106 Ph: (801) 359-3995 |
| NPI Number | 1760669998 |
|---|---|
| Provider Enumeration Date | 01/30/2008 |
| Last Update Date | 09/24/2014 |
| Medicare PECOS PAC ID | 7214821834 |
|---|---|
| Medicare Enrollment ID | O20040212000675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760669998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mark Dudley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689784019 PECOS PAC ID: 5294629812 Enrollment ID: I20040407000493 |
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