Provider Demographics
NPI:1851533947
Name:PRECISION HEALTH SERVICES
Entity Type:Organization
Organization Name:PRECISION HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESPIRATORY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:WIESE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:801-266-0399
Mailing Address - Street 1:4885 S 900 E
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5746
Mailing Address - Country:US
Mailing Address - Phone:801-266-0399
Mailing Address - Fax:
Practice Address - Street 1:4885 S 900 E
Practice Address - Street 2:SUITE 107
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-5746
Practice Address - Country:US
Practice Address - Phone:801-266-0399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6579371-5701261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)