Provider Demographics
NPI:1700999786
Name:ALSOP, MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:ALSOP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 666
Mailing Address - Street 2:
Mailing Address - City:MORONI
Mailing Address - State:UT
Mailing Address - Zip Code:84646-0666
Mailing Address - Country:US
Mailing Address - Phone:801-360-9122
Mailing Address - Fax:
Practice Address - Street 1:1045 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-5953
Practice Address - Country:US
Practice Address - Phone:801-360-9122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT161801-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor