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General NPI Number Information
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NPI Number | 1255255246
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL INTEGRATION STUDIOS LLC
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 1728 S 1160 E
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City | HEBER CITY
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State | UT
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Zip | 84032-1685
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Country | US
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Telephone | 904-504-3226
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Fax |
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Provider Business Mailing Address
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Address Line | 104 E 600 S STE 830
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City | HEBER CITY
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State | UT
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Zip | 84032-2365
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | ELZA VAN NIEKERK
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Credential |
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Telephone | 904-504-3226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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