Provider Demographics
NPI:1548822406
Name:TRUHEALTH PHYSICAL THERAPY & WELLNESS LLC
Entity type:Organization
Organization Name:TRUHEALTH PHYSICAL THERAPY & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-310-7304
Mailing Address - Street 1:1149 N CANYON RD
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3420
Mailing Address - Country:US
Mailing Address - Phone:801-939-3535
Mailing Address - Fax:801-939-3534
Practice Address - Street 1:1149 N CANYON RD
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3420
Practice Address - Country:US
Practice Address - Phone:801-939-3535
Practice Address - Fax:801-939-3534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy