| Mt. Olympus Clinic Of Chiropractic Corporation | |
|
715 E 3900 S Suite 205-a Salt Lake City UT 84107-2182 | |
| (801) 268-4993 | |
| (801) 268-4241 |
| Full Name | Mt. Olympus Clinic Of Chiropractic Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 715 E 3900 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Gregory Lewis Haddock (OWNER) |
| Authorized Official Contact | 8012684993 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt. Olympus Clinic Of Chiropractic Corporation 715 E 3900 S Suite 205-a Salt Lake City UT 84107-2182 Ph: (801) 268-4993 | Mt. Olympus Clinic Of Chiropractic Corporation 715 E 3900 S Suite 205-a Salt Lake City UT 84107-2182 Ph: (801) 268-4993 |
| NPI Number | 1043485188 |
|---|---|
| Provider Enumeration Date | 04/29/2008 |
| Last Update Date | 04/29/2008 |
| Medicare PECOS PAC ID | 3476560095 |
|---|---|
| Medicare Enrollment ID | O20060307000447 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043485188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 57703761202 (Utah) | Primary |
| Provider Name | Gregory L Haddock |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1679775563 PECOS PAC ID: 7719970946 Enrollment ID: I20060308000032 |
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