National Provider Identifier Database

THERAPEUTIC WELLNESS CENTER
Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)


Contact Information

THERAPEUTIC WELLNESS CENTER
5974 FASHION POINT DR
SUITE 100
SOUTH OGDEN, UT84403-4699
Phone: 801-479-9644
Fax: 801-479-9639
Website:
Specialty Taxonomy Code
* Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X

* Indicates primary specialty

NPI Profile & details for THERAPEUTIC WELLNESS CENTER

NPI Number 1174858823
Legal business name
LBN
THERAPEUTIC WELLNESS CENTER
Authorized official DAWN FIELDING - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 10/14/2009
Last updated 05/31/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • UT License #: 7487072-0161
  • UT Other: U000072054 MEDICARE PTAN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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