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Organization
PROACTIVE PAIN CENTER
Active
Organization
PROACTIVE PAIN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODIE CUNNINGHAM (OWNER)
(385) 414-6267
Entity
Organization
Contact information
Practice address
10965 S STATE ST, SANDY, UT 84070-4270
(385) 414-6267
Mailing address
10965 S STATE ST, SANDY, UT 84070-4270
(385) 414-6267
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
UT
305S00000X
Point of Service
—
UT
Other
Enumeration date
05/08/2015
Last updated
07/21/2022
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