Provider Demographics
NPI:1598979296
Name:KING CHIROPRACTIC INC
Entity type:Organization
Organization Name:KING CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-465-4999
Mailing Address - Street 1:865 S 500 W
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-3201
Mailing Address - Country:US
Mailing Address - Phone:801-465-4999
Mailing Address - Fax:801-465-0981
Practice Address - Street 1:865 S 500 W
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-3201
Practice Address - Country:US
Practice Address - Phone:801-465-4999
Practice Address - Fax:801-465-0981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2774304-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU83757Medicare UPIN
000056285Medicare ID - Type Unspecified