| Spine And Sports | |
|
3476 W 4600 S, West Haven, UT 84401-9203 | |
| (801) 689-0200 | |
| (801) 689-0201 |
| Full Name | Spine And Sports |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 3476 W 4600 S, West Haven, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487998431 | NPI | - | NPPES |
| 0701426657 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Secondary |
| Provider Name | Charity Sue Davis |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720018294 PECOS PAC ID: 7719927409 Enrollment ID: I20050516000264 |
| Provider Name | Chad J Tenney |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215910161 PECOS PAC ID: 9436050648 Enrollment ID: I20060504000357 |
| Provider Name | Leslye E Leslie |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811106156 PECOS PAC ID: 2769581099 Enrollment ID: I20150423002170 |
| Provider Name | Burke D Maughan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306861315 PECOS PAC ID: 2062447923 Enrollment ID: I20160311000016 |
| Provider Name | Kevin Austin Hanni |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437698883 PECOS PAC ID: 7719263573 Enrollment ID: I20170410000537 |
| Provider Name | Jared James Hultquist |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477030583 PECOS PAC ID: 5991059099 Enrollment ID: I20181107003672 |
| Provider Name | Bryce Parker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700339579 PECOS PAC ID: 0345501326 Enrollment ID: I20190114001145 |
| Provider Name | Susan Miller |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760586283 PECOS PAC ID: 7416348214 Enrollment ID: I20220105002764 |
| Provider Name | Bradley Allan Guymon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881331536 PECOS PAC ID: 2769866078 Enrollment ID: I20220906003150 |
| Provider Name | Garrett Hardy Jones |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154033967 PECOS PAC ID: 7810369246 Enrollment ID: I20230214000799 |
| Provider Name | Elizabeth Embury |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528549615 PECOS PAC ID: 7113264334 Enrollment ID: I20231115003155 |
| Provider Name | Jessika Allen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275124828 PECOS PAC ID: 5193165132 Enrollment ID: I20240424003152 |
| Provider Name | Jacob Robert Peel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780296301 PECOS PAC ID: 3870934110 Enrollment ID: I20240516003898 |
| Mailing Address | Practice Location Address |
|---|---|
| Spine And Sports Po Box 66, Hooper, UT 84315-0066 Ph: (801) 689-0200 | Spine And Sports 3476 W 4600 S, West Haven, UT 84401-9203 Ph: (801) 689-0200 |
Garrett Hardy Jones, Physical Therapist Medicare: Medicare Enrolled Practice Location: 3476 W 4600 S, West Haven, UT 84401 Phone: 801-689-0200 Fax: 801-689-0201 | |
Mr. Dennis Tracy Gilbert, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4607 Midland Dr, Suit 201, West Haven, UT 84401 Phone: 801-732-8700 Fax: 801-732-2103 | |
Chad Jeffrey Tenney, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3476 W 4600 S, West Haven, UT 84401 Phone: 801-689-0200 Fax: 801-689-0201 | |
Justin Denis Longhurst, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4640 S 3500 W, Suite 3, West Haven, UT 84401 Phone: 801-689-0200 Fax: 801-689-0201 | |
Mitch Lillywhite, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4640 S 3500 W, West Haven, UT 84401 Phone: 801-689-0200 | |
Kevin Hanni, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3476 W 4600 S, West Haven, UT 84401 Phone: 801-689-0200 Fax: 801-689-0201 |