Provider Demographics
NPI:1447029343
Name:SEASONS CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SEASONS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-878-9565
Mailing Address - Street 1:6243 S REDWOOD RD STE 230
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-6410
Mailing Address - Country:US
Mailing Address - Phone:801-878-9565
Mailing Address - Fax:352-811-1122
Practice Address - Street 1:6243 S REDWOOD RD STE 230
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-6410
Practice Address - Country:US
Practice Address - Phone:801-878-9565
Practice Address - Fax:352-811-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty