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General NPI Number Information
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NPI Number | 1346977352
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Entity Type | Organization
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Legal Business Name | FT NERVE GROUP PLLC
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Dates
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Enumeration Date | 08/01/2022
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 476 N 900 W STE B
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City | AMERICAN FORK
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State | UT
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Zip | 84003-5201
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Country | US
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Telephone | 801-973-1373
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Fax |
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Provider Business Mailing Address
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Address Line | 770 E MAIN ST STE 356
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City | LEHI
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State | UT
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Zip | 84043-2293
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Country | US
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Telephone | 801-973-1373
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PERDRO ARLISS FERNANDEZ
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Credential |
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Telephone | 201-887-9610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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