Advanced Therapy Clinic LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

6094910-0160 Issued in UT

Legal business name

ADVANCED THERAPY CLINIC LLC

Practice address

875 E 530 N
Rear
American Fork, UT 84003-1955

Phone

(801) 427-8887

Fax

(801) 756-3444

NPI assigned

Feb 12, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kay Marie Smith, N.C.T.M.B., L.L.C.C

Title

Partner

Phone

(801) 380-8480

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184766826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 E 530 N",
            "address_2": "REAR",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840031965",
            "telephone_number": "801-427-8887",
            "fax_number": "801-756-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 E 530 N",
            "address_2": "REAR",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840031955",
            "telephone_number": "801-427-8887",
            "fax_number": "801-756-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED THERAPY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "801-380-8480",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "N.C.T.M.B., L.L.C.C"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "UT",
            "license": "6094910-0160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.