Organization
ADVANCED PHYSICAL THERAPY AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIS CLYDE PT (OWNER/PT)
(435) 654-0410
Entity
Organization
Contact information
Practice address
999 MURRAY HOLLADAY ROAD, #102, HOLLADAY, UT 84117
(385) 388-4994
(435) 654-3314
Mailing address
P.O. BOX 13, HEBER CITY, UT 84032
(385) 388-4994
(435) 654-0440
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1173432401
UT
Other
Enumeration date
03/01/2010
Last updated
08/30/2016
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