Provider Demographics
NPI:1366800260
Name:TLC, LLC
Entity type:Organization
Organization Name:TLC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:HIMELRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:435-525-1877
Mailing Address - Street 1:1062 E RIVERSIDE DR STE 204
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-5161
Mailing Address - Country:US
Mailing Address - Phone:435-525-1877
Mailing Address - Fax:435-215-7665
Practice Address - Street 1:1062 E RIVERSIDE DR STE 204
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5161
Practice Address - Country:US
Practice Address - Phone:435-525-1877
Practice Address - Fax:435-215-7665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty