Enterprise Valley Physical Therapy | |
660 E Main St, Bldg B, Enterprise, UT 84725-0549 | |
(435) 878-2722 | |
(435) 878-2723 |
Full Name | Enterprise Valley Physical Therapy |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 660 E Main St, Enterprise, Utah |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932363082 | NPI | - | NPPES |
P00669998 | Other | UT | RAIL ROAD MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 7043969-2401 (Utah) | Primary |
Provider Name | Wyatt Banks |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1417000753 PECOS PAC ID: 4183931348 Enrollment ID: I20150921001325 |
Mailing Address | Practice Location Address |
---|---|
Enterprise Valley Physical Therapy Po Box 549, Enterprise, UT 84725-0549 Ph: (775) 726-3117 | Enterprise Valley Physical Therapy 660 E Main St, Bldg B, Enterprise, UT 84725-0549 Ph: (435) 878-2722 |
Marcus T Burton, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 660 E Main St Suite B, Enterprise, UT 84725 Phone: 775-726-3117 Fax: 775-726-3118 | |
Mr. Wyatt D Banks, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 660 E Main St Bldg B, Enterprise, UT 84725 Phone: 435-878-2722 Fax: 435-878-2723 | |
Mr. Lonnie J Truman, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 660 E Main St, Suite B, Enterprise, UT 84725 Phone: 435-878-2722 Fax: 775-726-3118 |