Provider Demographics
NPI:1972722916
Name:GUTHRIE, DANIEL RUSSELL (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:RUSSELL
Last Name:GUTHRIE
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 1:3856 W 5400 S
Mailing Address - Street 2:120
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84118-3579
Mailing Address - Country:US
Mailing Address - Phone:801-957-9696
Mailing Address - Fax:801-957-9694
Practice Address - Street 1:3856 W 5400 S
Practice Address - Street 2:120
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84118-3579
Practice Address - Country:US
Practice Address - Phone:801-957-9696
Practice Address - Fax:801-957-9694
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT176424-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor