Provider Demographics
NPI:1528259371
Name:1ST CHOICE CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:1ST CHOICE CHIROPRACTIC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LOREN
Authorized Official - Last Name:MASSENGALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-969-4700
Mailing Address - Street 1:1951 W 4700 S
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84118-1108
Mailing Address - Country:US
Mailing Address - Phone:801-969-4700
Mailing Address - Fax:801-969-7217
Practice Address - Street 1:1951 W 4700 S
Practice Address - Street 2:SUITE 2
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84118-1108
Practice Address - Country:US
Practice Address - Phone:801-969-4700
Practice Address - Fax:801-969-7217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty