Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2725621202 | UT |
N | 111NN0400X | Neurology | 2725621202 | UT |
NPI | 1730165606 |
---|---|
Provider Name | Carl Kirt Salmon |
First Address | St George, UT 84770-3010 |
Second Address | St George, UT 84770-3010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 05/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U48331 | (02) | UT |