Provider Demographics
NPI:1033849369
Name:PELVIC CLARITY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:PELVIC CLARITY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MADISON
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAINHOWER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:801-941-1090
Mailing Address - Street 1:511 S 700 E
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84335-1352
Mailing Address - Country:US
Mailing Address - Phone:801-941-1090
Mailing Address - Fax:
Practice Address - Street 1:2245 N 400 E
Practice Address - Street 2:STE. 201
Practice Address - City:NORTH LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341
Practice Address - Country:US
Practice Address - Phone:801-941-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy