Basic Information
| Provider Information | |||||||||
| NPI: | 1093075756 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SPRINGCREEK MEDICAL CENTER PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 267 SPRINGCREEK PARKWAY | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4359729400 | ||||||||
| FaxNumber: | 4357924800 | ||||||||
| Practice Location | |||||||||
| Address1: | 267 N SPRING CREEK PKWY | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 843329775 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4359729400 | ||||||||
| FaxNumber: | 4357924800 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2012 | ||||||||
| LastUpdateDate: | 04/08/2013 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | GARVERT | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | SCOTT | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/CHIROPRACTOR | ||||||||
| AuthorizedOfficialTelephone: | 4359729400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 4788778-1202 | UT | Y | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.