WILDE HEART PT LLC


Address: 3333 S 900 E Ste 140, Millcreek, UT 84106-2211
Phone: 8018245424

WILDE HEART PT LLC (NPI# 1134642911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134642911
Entity Type Organization
Organization Name WILDE HEART PT LLC
Practice Address 3333 S 900 E Ste 140
Millcreek
UT 84106-2211
Practice Telephone 8018245424
Enumeration Date 2017-07-24
Last Update Date 2018-03-17
Authorized Official Name HEATHER WILDE (OWNER, PHYSICAL THERAPIST)
Authorized Official Telephone 8018245424
Authorized Official Credential PT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2000X Clinic/Center
Specialization: Physical Therapy
5647258-2401 UT Ambulatory Health Care Facilities

Provider Secondary Practice Location

Address Telephone Number Fax Number
982 E Montclair Dr, Millcreek, UT 841062018 8018245424

Office Location

Street Address 3333 S 900 E STE 140
City MILLCREEK
State UT
Zip Code 84106-2211

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Taxonomy Information

Taxonomy Code 261QP2000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Physical Therapy

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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Competitor

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City MILLCREEK
Zip Code 84106

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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