Provider Demographics
NPI:1124685508
Name:COMPREHENSIVE CHIROPRACTIC AND RECOVERY
Entity type:Organization
Organization Name:COMPREHENSIVE CHIROPRACTIC AND RECOVERY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESS
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-678-0723
Mailing Address - Street 1:1684 W REUNION AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-4609
Mailing Address - Country:US
Mailing Address - Phone:801-562-0502
Mailing Address - Fax:
Practice Address - Street 1:1684 W REUNION AVE STE 100
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-4609
Practice Address - Country:US
Practice Address - Phone:801-562-0502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE CHIROPRACTIC AND RECOVERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-21
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service