Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 2935441202 | UT |
NPI | 1124192042 |
---|---|
Provider Name | Dr. Dale Harland Heath |
First Address | Orem, UT 84097-6322 |
Second Address | Orem, UT 84097-6322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 26/01/2012 |