Provider Demographics
NPI:1285013987
Name:SPORTSMED ASSOCIATES LLC
Entity Type:Organization
Organization Name:SPORTSMED ASSOCIATES LLC
Other - Org Name:PHYSICIANS OF ADVANCE SPORTS & ORTHOPEDIC MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:801-753-7770
Mailing Address - Street 1:3401 N CENTER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7498
Mailing Address - Country:US
Mailing Address - Phone:801-753-7770
Mailing Address - Fax:801-753-7775
Practice Address - Street 1:3401 N CENTER ST
Practice Address - Street 2:STE 100
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-7497
Practice Address - Country:US
Practice Address - Phone:801-400-7307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty