| |
35 South Main, Randolph, UT 84064 | |
(435) 793-7000 | |
(435) 946-9777 |
Full Name | |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 35 South Main, Randolph, Utah |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609085885 | NPI | - | NPPES |
816 | Other | UT | RANDOLPH CITY LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 351974-2401 (Utah) | Primary |
Mailing Address | Practice Location Address |
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Po Box 276, Garden City, UT 84028-0276 Ph: (435) 946-2777 | 35 South Main, Randolph, UT 84064 Ph: (435) 793-7000 |