Provider Demographics
NPI:1649462136
Name:APPLEGATE, KIRK ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:ALLEN
Last Name:APPLEGATE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 E 5900 S
Mailing Address - Street 2:SUITE B107
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7257
Mailing Address - Country:US
Mailing Address - Phone:801-313-0111
Mailing Address - Fax:801-313-0116
Practice Address - Street 1:166 E 5900 S
Practice Address - Street 2:SUITE B107
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7257
Practice Address - Country:US
Practice Address - Phone:801-313-0111
Practice Address - Fax:801-313-0116
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1743231202111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation