=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336836758
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADEPT MOTION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2023
-----------------------------------------------------
Last Update Date | 04/18/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1284 E CENTER ST
-----------------------------------------------------
City | SPANISH FORK
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84660-2319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 458-219-5874
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1284 E CENTER ST
-----------------------------------------------------
City | SPANISH FORK
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84660-2319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 458-219-5874
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | JUSTIN KITCHEN
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 458-219-5874
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------