| Organization Name: | SPANISH FORK FAMILY CHIROPRACTIC |
| NPI Number: | 1073892659 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTOPHER CADE BRODERICK (MANAGER) |
| Mailing Address: | 729 N Main St Spanish Fork |
| State: | UT US |
| Postal Code: | 846601146 |
| Phone Number: | 8018045342 |
| Fax Number: | 8778257020 |
| NPI Enumeration Date: | 08/12/2011 |
| NPI Last Update Date: | 08/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 7952725-1202 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |