Provider Demographics
NPI:1285173294
Name:ALIGNMENT AND PERFORMANCE CENTER OF UTAH, PLLC
Entity type:Organization
Organization Name:ALIGNMENT AND PERFORMANCE CENTER OF UTAH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:ARBUCKLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:610-952-2172
Mailing Address - Street 1:912 N 2000 W
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-4047
Mailing Address - Country:US
Mailing Address - Phone:801-756-2861
Mailing Address - Fax:801-492-1882
Practice Address - Street 1:912 N 2000 W
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-4047
Practice Address - Country:US
Practice Address - Phone:801-756-2861
Practice Address - Fax:801-492-1882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10137197-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty