| Rocky Mountain University Of Health Professions Foundation | |
|
122 E 1700 S Bldg 3 Provo UT 84606-5644 | |
| (801) 915-5281 | |
| Not Available |
| Full Name | Rocky Mountain University Of Health Professions Foundation |
|---|---|
| Speciality | Physical Therapist |
| Location | 122 E 1700 S Bldg 3, Provo, Utah |
| Authorized Official Name and Position | Jeffrey Bate (TREASURER) |
| Authorized Official Contact | 8019155281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Mountain University Of Health Professions Foundation 1800 Novell Pl Provo UT 84606-6171 Ph: () - | Rocky Mountain University Of Health Professions Foundation 122 E 1700 S Bldg 3 Provo UT 84606-5644 Ph: (801) 915-5281 |
| NPI Number | 1053174417 |
|---|---|
| Provider Enumeration Date | 01/30/2024 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/18/2024 |
| Medicare PECOS PAC ID | 7810439130 |
|---|---|
| Medicare Enrollment ID | O20240603000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053174417 | NPI | - | NPPES |
| Provider Name | Brandon J Wilde |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710140447 PECOS PAC ID: 8527500842 Enrollment ID: I20240603000249 |
| Provider Name | Crystal Miskin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396258133 PECOS PAC ID: 7810250941 Enrollment ID: I20240606002378 |
| Provider Name | Ross Stephen White |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770996472 PECOS PAC ID: 8426590290 Enrollment ID: I20240607001696 |
| Provider Name | Tyler Luszeck |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578958179 PECOS PAC ID: 7012459761 Enrollment ID: I20240610000974 |
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