Organization
FUNCTIONFIRST REHABILITATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN HACKING OTR (OWNER)
(801) 660-7613
Entity
Organization
Contact information
Practice address
2314 WEST PEPPERCORN RD, LEHI, UT 84043
(801) 660-7613
Mailing address
2314 WEST PEPPERCORN RD, LEHI, UT 84043
(801) 660-7613
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
4971361-4201
UT
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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