Provider Demographics
NPI:1821969577
Name:ADVANCE SPINE AND FUNCTION LLC
Entity type:Organization
Organization Name:ADVANCE SPINE AND FUNCTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNOR
Authorized Official - Middle Name:T
Authorized Official - Last Name:UTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:574-370-3689
Mailing Address - Street 1:972 SUMMER HILL CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:IN
Mailing Address - Zip Code:46540-9273
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1709 E BRISTOL ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-6606
Practice Address - Country:US
Practice Address - Phone:574-264-9174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-16
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty