Organization
INTEGRATED CLINICAL EXCELLENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SPENCER NEPHI CLARK PT, DPT, MBA (OWNER/CEO)
(801) 822-1880
Entity
Organization
Contact information
Practice address
4337 W OXFORD ST, CEDAR HILLS, UT 84062-8638
(801) 822-1880
(801) 695-1595
Mailing address
4337 W OXFORD ST, CEDAR HILLS, UT 84062-8638
(801) 822-1880
(801) 695-1595
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
Primary
—
—
2251C2600X
Cardiopulmonary Physical Therapist
—
—
2251E1200X
Ergonomics Physical Therapist
—
—
2251G0304X
Geriatric Physical Therapist
—
—
2251H1200X
Hand Physical Therapist
—
—
2251N0400X
Neurology Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/24/2018
Last updated
03/24/2018
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