Provider Demographics
NPI:1063799831
Name:HIGH DESERT CHIROPRACTIC AND WELLNESS, PC
Entity type:Organization
Organization Name:HIGH DESERT CHIROPRACTIC AND WELLNESS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:H
Authorized Official - Last Name:CLUFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:435-644-2225
Mailing Address - Street 1:310 S 100 E
Mailing Address - Street 2:SUITE #8
Mailing Address - City:KANAB
Mailing Address - State:UT
Mailing Address - Zip Code:84741-3681
Mailing Address - Country:US
Mailing Address - Phone:435-644-2225
Mailing Address - Fax:435-553-0941
Practice Address - Street 1:310 S 100 E
Practice Address - Street 2:SUITE #8
Practice Address - City:KANAB
Practice Address - State:UT
Practice Address - Zip Code:84741-3681
Practice Address - Country:US
Practice Address - Phone:435-644-2225
Practice Address - Fax:435-553-0941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6876966-1202261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center