Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 174276-1202 | UT |
Y | 111NS0005X | Chiropractic Sports Physician | 4045 | IA |
NPI | 1366509168 |
---|---|
Provider Name | Dr. Raymond Scott Binkerd |
First Address | Murray, UT 84107-6261 |
Second Address | Murray, UT 84107-6261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 11/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1742761202 | UTAH STATE LICENSE (01) | UT |