Healthcare Provider Details

I. General information

NPI: 1558530410
Provider Name (Legal Business Name): RICK D. POINTER RRT, CPFT, RPSGT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 MILLBROOK RD
HEBER CITY UT
84032-3032
US

IV. Provider business mailing address

182 MILLBROOK RD
HEBER CITY UT
84032-3032
US

V. Phone/Fax

Practice location:
  • Phone: 435-654-3460
  • Fax:
Mailing address:
  • Phone: 435-654-3460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number18
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number91-115994-5701
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number1047
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: