Provider Demographics
NPI:1275021784
Name:AXIS CHIROPRACTIC AND MASSAGE CLINIC, LLC
Entity type:Organization
Organization Name:AXIS CHIROPRACTIC AND MASSAGE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ANNELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-347-5374
Mailing Address - Street 1:5894 S UTAHNA DR
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5930
Mailing Address - Country:US
Mailing Address - Phone:801-347-5374
Mailing Address - Fax:
Practice Address - Street 1:1681 W 3860 S STE 106
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-6274
Practice Address - Country:US
Practice Address - Phone:801-997-0280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9806097261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center