National Provider Identifier Database

ALTAVISTA HEALTHCARE GROUP LLC
Rehabilitation


Contact Information

ALTAVISTA HEALTHCARE GROUP, LLC
154 E MYRTLE AVE STE 100
MURRAY, UT84107-4850
Phone: 210-249-4949
Fax:
Website:
Specialty Taxonomy Code
* Rehabilitation 261QR0400X

* Indicates primary specialty

NPI Profile & details for ALTAVISTA HEALTHCARE GROUP, LLC

NPI Number 1699258954
Legal business name
LBN
ALTAVISTA HEALTHCARE GROUP, LLC
Authorized official BLANCA CORRIE - (CEO)
Entity Organization
Organization subpart No
Enumeration date 09/12/2018
Last updated 09/12/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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