Healthcare Provider Details

I. General information

NPI: 1851686711
Provider Name (Legal Business Name): ADVANCED THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 SOUTH OREM BLVD.
OREM UT
84058-3009
US

IV. Provider business mailing address

257 SOUTH OREM BLVD
OREM UT
84058-3009
US

V. Phone/Fax

Practice location:
  • Phone: 801-225-1080
  • Fax: 801-225-1069
Mailing address:
  • Phone: 801-225-1080
  • Fax: 801-225-1069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. AARON JENKINS
Title or Position: ADMINISTRATOR/MEMBER
Credential:
Phone: 801-400-3073