Organization
WELLSPRING PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA J CLARK P.T. (OWNER/PHYSICAL THERAPIST)
(435) 657-0123
Entity
Organization
Contact information
Practice address
210 E MAIN ST STE 111, MIDWAY, UT 84049-6828
(435) 657-0123
(435) 657-0330
Mailing address
210 E MAIN ST STE 111, MIDWAY, UT 84049-6828
(435) 657-0123
(435) 657-0330
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
116187-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11618724000001
BCBS
UT
05
—
5291725170001
—
UT
01
—
64-00532
UNITEDHEALTHCARE
UT
01
—
67054
PEHP
UT
Enumeration date
10/18/2006
Last updated
03/17/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up