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General NPI Number Information
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NPI Number | 1033849369
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Entity Type | Organization
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Legal Business Name | PELVIC CLARITY PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 2245 N 400 E STE. 201
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City | NORTH LOGAN
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State | UT
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Zip | 84341
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Country | US
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Telephone | 801-941-1090
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Fax |
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Provider Business Mailing Address
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Address Line | 511 S 700 E
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City | SMITHFIELD
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State | UT
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Zip | 84335-1352
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Country | US
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Telephone | 801-941-1090
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Fax |
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Authorized Official
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Title or Position | MANAGER/PHYSICAL THERAPIST
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Name | MADISON SPAINHOWER
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Credential | DPT
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Telephone | 801-941-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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