NPI 1003088402

Provo Sports and Family Chiropractic, INC.

Organisation Sports Physician Chiropractor Provo, UT

Practice location

Address: 777 N 500 W STE 205, Provo, UT 84601-1596
Phone: (801) 375-2420
Fax: (801) 374-8588

Authorised official

Name: Eric J Brady
Title: Chiropractor
Phone: (801) 375-2420

Registered specialties

Sports Physician Chiropractor Primary

Chiropractic Providers Taxonomy 111NS0005X Licence 355063-1202 (UT)

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Registry record

NPI: 1003088402
Entity type: Organization
NPI issued: 26 Mar 2008
Record last updated: 28 Mar 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.