| Proform Athletics, Llc | |
|
7600 Glenwild Dr, Park City, UT 84098-5587 | |
| (435) 901-1139 | |
| (435) 940-9127 |
| Full Name | Proform Athletics, Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist - Orthopedic |
| Location | 7600 Glenwild Dr, Park City, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689909772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | 4945243-2401 (Utah) | Primary |
| Provider Name | Thomas E Bezemer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679628002 PECOS PAC ID: 5890838957 Enrollment ID: I20100211000521 |
| Mailing Address | Practice Location Address |
|---|---|
| Proform Athletics, Llc 7461 Brook Hollow Loop Rd, Park City, UT 84098-8262 Ph: (435) 901-1139 | Proform Athletics, Llc 7600 Glenwild Dr, Park City, UT 84098-5587 Ph: (435) 901-1139 |
Kathleen S Bochnowski, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 6030 Market St, Suite 135, Park City, UT 84098 Phone: 435-575-0345 Fax: 435-575-0346 | |
Avery Nicole Alexander, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1850 Sidewinder Dr, Park City, UT 84060 Phone: 435-645-9095 | |
Mrs. Larissa Gizelle Neal, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1640 Redstone Center Dr, 200, Park City, UT 84098 Phone: 888-800-8744 | |
Kristen Prejean, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1640 Redstone Ctr Dr, Park City, UT 84098 Phone: 888-800-8744 | |
Sandra Michele Saluti, M.S.,P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1640 Redstone Center Dr, Park City, UT 84098 Phone: 888-800-8744 | |
Sarah B Vaughan, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1640 Redstone Center Dr, Suite 200, Park City, UT 84098 Phone: 866-474-6677 | |
Ms. Kieran Angelica Glenbockie, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1640 Redstone Center Dr, Suite 200, Park City, UT 84098 Phone: 888-800-8744 |