# BODY TUNE PHYSICAL THERAPY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952522419
- **Authorized official:** KORRYN WIESE PT (CEO)
- **Authorized official phone:** (801) 391-1585

## Contact information

- **Practice address:** 5856 HARRISON BLVD STE A, SOUTH OGDEN, UT 84403-2117
- **Practice address phone:** (801) 475-6415
- **Practice address fax:** (801) 475-6417
- **Mailing address:** 5856 HARRISON BLVD, SUITE A, SOUTH OGDEN, UT 84403-4397
- **Mailing address phone:** (801) 475-6415
- **Mailing address fax:** (801) 475-6417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 1179052401 | UT | Yes |

## Other

- **Enumeration date:** 05/01/2007
- **Last updated:** 04/22/2020