Avant-Garde LLC

NPI #1164935664 in Orem, Utah

Provider Information

NPI Number: 1164935664
Entity Type: Organization
Organization Name: Avant-Garde LLC
Primary Specialty: Physical Therapist
Enumeration Date: Nov 7, 2017
Last Updated: Nov 7, 2017

Practice Location

Address: 293 E 930 S
City: Orem
State: Utah
ZIP Code: 84058-5001
Phone: (801) 548-3417

Authorized Official

Name: BROCK LARSON ROBERTS
Title: MANAGING DIRECTOR
Phone: (801) 548-3417

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X
Physical Therapist	225100000X	Primary

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