Healthcare Provider Details
I. General information
NPI: 1497681050
Provider Name (Legal Business Name): DYNAMIC SUPPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2089 WOODVIEW DR
LEHI UT
84048-5022
US
IV. Provider business mailing address
2089 WOODVIEW DR
LEHI UT
84048-5022
US
V. Phone/Fax
- Phone: 702-773-6873
- Fax:
- Phone: 702-773-6873
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TYLOR
MUSE
Title or Position: OWNER
Credential:
Phone: 702-773-6873