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MISUSTIN CHIROPRACTIC PC NPI 1801070628


NPI Information

NPI: 1801070628
Provider Name: MISUSTIN CHIROPRACTIC PC

Doing Business As: PETERSON CHIROPRACTIC CLINIC

Classification: Chiropractor - 111NS0005X
Entity Type: Organization

Specialization: Sports Physician

Address:
1415 N 400 E
SUITE A
LOGAN, UT
ZIP 84341
Phone: (435) 753-2840
Get Directions

MISUSTIN CHIROPRACTIC PC is a sports physician chiropractor in Logan, UT. The provider is a sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. MISUSTIN CHIROPRACTIC PC NPI is 1801070628. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Peterson Chiropractic Clinic.

The provider's business location address is:

1415 N 400 E
SUITE A
LOGAN, UT
ZIP 84341-539
Phone: (435) 753-2840
Fax: (435) 787-9422

The provider's authorized official is James Lawrence Misustin .
The authorized official title is Owner and has the following contact phone number (435) 753-2840.

The enumeration date for this NPI number is 12/28/2007 and was last updated on 2/27/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111NS0005XChiropractorSports Physician320260-1202UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1T05589MEDICARE UPINUTAH
2554155506001MEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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