Provider Demographics
NPI:1871156091
Name:TRAVERSE HEALTH
Entity type:Organization
Organization Name:TRAVERSE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:POUND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-980-0002
Mailing Address - Street 1:2183 W MAIN ST STE A204
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-6762
Mailing Address - Country:US
Mailing Address - Phone:801-980-0002
Mailing Address - Fax:925-891-7836
Practice Address - Street 1:2183 W MAIN ST STE A204
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-6762
Practice Address - Country:US
Practice Address - Phone:801-980-0002
Practice Address - Fax:925-891-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty