Healthcare Provider Details

I. General information

NPI: 1366901704
Provider Name (Legal Business Name): ASPIRE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 N 1450 E
NORTH LOGAN UT
84341-2086
US

IV. Provider business mailing address

PO BOX 5
MILLVILLE UT
84326-0005
US

V. Phone/Fax

Practice location:
  • Phone: 435-363-3732
  • Fax: 888-668-5207
Mailing address:
  • Phone: 435-232-1850
  • Fax: 888-668-5207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: TIM L JENSEN
Title or Position: OWNER
Credential: OT
Phone: 435-363-3732