1598701773 NPI number — DR. HENRY DAVID HUNT DPT, OCS, CSCS

Table of content: DR. HENRY DAVID HUNT DPT, OCS, CSCS (NPI 1598701773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598701773 NPI number — DR. HENRY DAVID HUNT DPT, OCS, CSCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNT
Provider First Name:
HENRY
Provider Middle Name:
DAVID
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPT, OCS, CSCS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUNT
Provider Other First Name:
H
Provider Other Middle Name:
DAVID
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT, OCS, CSCS
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1598701773
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPANISH FORK
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84660-1726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-436-3110
Provider Business Mailing Address Fax Number:
385-200-2246

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 N MAIN ST
Provider Second Line Business Practice Location Address:
ADVANCED WELLNESS CENTER
Provider Business Practice Location Address City Name:
SPANISH FORK
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-436-3110
Provider Business Practice Location Address Fax Number:
385-200-2246
Provider Enumeration Date:
06/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  7654055-2401 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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