| Theratech Tx | |
|
95 W 100 S Ste 102&126 Logan UT 84321-5810 | |
| (435) 592-9874 | |
| Not Available |
| Full Name | Theratech Tx |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 95 W 100 S Ste 102&126, Logan, Utah |
| Authorized Official Name and Position | Stacy Jones (OWNER) |
| Authorized Official Contact | 4355929874 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theratech Tx 95 W 100 S Ste 102&126 Logan UT 84321-5810 Ph: (435) 592-9874 | Theratech Tx 95 W 100 S Ste 102&126 Logan UT 84321-5810 Ph: (435) 592-9874 |
| NPI Number | 1912676842 |
|---|---|
| Provider Enumeration Date | 09/13/2021 |
| Last Update Date | 09/13/2021 |
| Certification Date | 09/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912676842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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