Provider Demographics
NPI:1588965644
Name:APOLLO CHIROPRACTIC, PC
Entity type:Organization
Organization Name:APOLLO CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-685-2862
Mailing Address - Street 1:5882 S 900 E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1683
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5882 S 900 E
Practice Address - Street 2:SUITE 100
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84121-1683
Practice Address - Country:US
Practice Address - Phone:801-685-2862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3632311202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty