Organization
ULTIMATE SPORTS REGENERATIVE MEDICINE
Active
Parent organization
ULTIMATE SPORTS REGENERATIVE MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ULTIMATE SPORTS REGENERATIVE MEDICINE
Authorized official
PATRICK GARCIA (DIRECT OWNER)
(801) 254-5800
Entity
Organization
Contact information
Practice address
1098 W. SOUTH JORDAN PKWY, SUITE 101, SOUTH JORDAN, UT 84095
(801) 254-5800
(801) 254-1696
Mailing address
1098 W SOUTH JORDAN PKWY, SUITE 101, SOUTH JORDAN, UT 84095-9366
(801) 254-5800
(801) 254-1696
Taxonomy
Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
7058178-1202
UT
363L00000X
Nurse Practitioner
Primary
347183-4405
UT
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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