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Contact Information

PROACTIVE PAIN CENTER
10965 S STATE ST
SANDY, UT84070-4270
 Phone: 385-414-6267
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
 

Point of Service

305S00000X
Indicates primary specialty

NPI Profile & details for PROACTIVE PAIN CENTER

NPI Number 1770961955
LBN Legal business name PROACTIVE PAIN CENTER
Authorized official JODIE CUNNINGHAM - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/08/2015
Last updated 07/21/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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