Provider Demographics
NPI:1811122021
Name:TRU HEALTH CENTER
Entity type:Organization
Organization Name:TRU HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-254-0309
Mailing Address - Street 1:247 W 12300 S
Mailing Address - Street 2:1 B
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9560
Mailing Address - Country:US
Mailing Address - Phone:801-631-9902
Mailing Address - Fax:801-553-1560
Practice Address - Street 1:247 W 12300 S
Practice Address - Street 2:1 B
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9560
Practice Address - Country:US
Practice Address - Phone:801-631-9902
Practice Address - Fax:801-553-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT73368270142174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty