Provider Demographics
NPI:1952630832
Name:STRAINS & PAINS CLINIC
Entity Type:Organization
Organization Name:STRAINS & PAINS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAYNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERMANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:801-542-7111
Mailing Address - Street 1:877 E 12300 S STE 201
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8262
Mailing Address - Country:US
Mailing Address - Phone:801-542-7111
Mailing Address - Fax:801-542-7112
Practice Address - Street 1:877 E 12300 S STE 201
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8262
Practice Address - Country:US
Practice Address - Phone:801-542-7111
Practice Address - Fax:801-542-7112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5831697-1204208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty