Provider Demographics
NPI:1184378630
Name:GLOBAL PAIN CLINIC LLC
Entity type:Organization
Organization Name:GLOBAL PAIN CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-400-2233
Mailing Address - Street 1:488 N 100 W
Mailing Address - Street 2:
Mailing Address - City:BLANDING
Mailing Address - State:UT
Mailing Address - Zip Code:84511-3505
Mailing Address - Country:US
Mailing Address - Phone:801-400-2233
Mailing Address - Fax:
Practice Address - Street 1:488 N 100 W
Practice Address - Street 2:
Practice Address - City:BLANDING
Practice Address - State:UT
Practice Address - Zip Code:84511-3505
Practice Address - Country:US
Practice Address - Phone:801-400-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty