Organization
PACIFIC DRIVE MEDICAL CENTER, INC.
Active
Other names
Utah Pain Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC C LEE DC (TREASURER)
(801) 756-7800
Entity
Organization
Contact information
Practice address
999 E PACIFIC DRIVE, AMERICAN FORK, UT 84003-3033
(801) 756-7800
(801) 756-7805
Mailing address
999 E PACIFIC DRIVE, AMERICAN FORK, UT 84003-3033
(801) 756-7800
(801) 756-7805
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
—
—
111NR0400X
Rehabilitation Chiropractor
—
—
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DP1898
RAILROAD MEDICARE PTAN
UT
Enumeration date
12/09/2008
Last updated
06/25/2014
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