Organization
INTEGRATED CLINIX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER CARK PT, DPT, MBA (OWNER)
(801) 822-1880
Entity
Organization
Contact information
Practice address
4337 W OXFORD ST, CEDAR HILLS, UT 84062-8638
(801) 822-1880
(801) 692-1595
Mailing address
4337 W OXFORD ST, CEDAR HILLS, UT 84062-8638
(801) 822-1880
(801) 692-1595
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2019
Last updated
04/29/2021
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