Provider Demographics
NPI:1154766749
Name:WASATCH SPINAL CARE PLLC
Entity type:Organization
Organization Name:WASATCH SPINAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:K
Authorized Official - Last Name:FRANDSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-508-2996
Mailing Address - Street 1:8706 S 700 E
Mailing Address - Street 2:STE 103
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-1807
Mailing Address - Country:US
Mailing Address - Phone:801-508-2996
Mailing Address - Fax:801-508-2981
Practice Address - Street 1:8706 S 700 E
Practice Address - Street 2:STE 103
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-1807
Practice Address - Country:US
Practice Address - Phone:801-508-2996
Practice Address - Fax:801-508-2981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5694081-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty