Healthcare Provider Details

I. General information

NPI: 1265904064
Provider Name (Legal Business Name): WHEELCHAIR CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4557 S WESTERN ST STE B4
AMARILLO TX
79109-8044
US

IV. Provider business mailing address

2021 E VILLAGE GREEN CIR STE C
DRAPER UT
84020-5500
US

V. Phone/Fax

Practice location:
  • Phone: 833-233-7875
  • Fax: 801-206-3059
Mailing address:
  • Phone: 801-440-5592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DANNY LUMPKIN
Title or Position: PRESIDENT
Credential:
Phone: 801-440-5592