Provider Demographics
NPI:1356122469
Name:THERAPEUTIX OF CLINTON LLC
Entity type:Organization
Organization Name:THERAPEUTIX OF CLINTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-388-7621
Mailing Address - Street 1:5898 MAIN POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-4866
Mailing Address - Country:US
Mailing Address - Phone:801-388-7621
Mailing Address - Fax:
Practice Address - Street 1:1808 W 1800 N STE A
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:UT
Practice Address - Zip Code:84015-8503
Practice Address - Country:US
Practice Address - Phone:801-217-3133
Practice Address - Fax:801-528-5067
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THERAPEUTIX MIND & BODY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty