Provider Demographics
NPI:1659116234
Name:RICE, KEREN REBEKAH (DC)
Entity type:Individual
Prefix:DR
First Name:KEREN
Middle Name:REBEKAH
Last Name:RICE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 S 100 E STE 104
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-2751
Mailing Address - Country:US
Mailing Address - Phone:801-785-9411
Mailing Address - Fax:
Practice Address - Street 1:405 S 100 E STE 104
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2751
Practice Address - Country:US
Practice Address - Phone:801-785-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13838326-1202111NR0400X, 111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
No111NR0400XChiropractic ProvidersChiropractorRehabilitation