Provider Demographics
NPI:1033568035
Name:AJ & B VANDUGTEREN LLP
Entity Type:Organization
Organization Name:AJ & B VANDUGTEREN LLP
Other - Org Name:THERAPEUTIX MASSAGE CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-737-0322
Mailing Address - Street 1:1144 W 2700 N
Mailing Address - Street 2:SUITE #300
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:UT
Mailing Address - Zip Code:84404-1222
Mailing Address - Country:US
Mailing Address - Phone:801-737-0322
Mailing Address - Fax:
Practice Address - Street 1:1144 W 2700 N
Practice Address - Street 2:SUITE #300
Practice Address - City:PLEASANT VIEW
Practice Address - State:UT
Practice Address - Zip Code:84404-1222
Practice Address - Country:US
Practice Address - Phone:801-737-0322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3086208-4701174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty