Provider Demographics
NPI:1598928541
Name:DYNATRONICS
Entity Type:Organization
Organization Name:DYNATRONICS
Other - Org Name:THERATECH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KELVYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CULLIMORE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:800-874-6251
Mailing Address - Street 1:7030 PARK CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6618
Mailing Address - Country:US
Mailing Address - Phone:800-874-6251
Mailing Address - Fax:801-568-7711
Practice Address - Street 1:7030 PARK CENTRE DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-6618
Practice Address - Country:US
Practice Address - Phone:800-874-6251
Practice Address - Fax:801-568-7711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment