| |
3303 N University Ave, Provo, UT 84604-4438 | |
(801) 373-7438 | |
(801) 373-7486 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 3303 N University Ave, Provo, Utah |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447275946 | NPI | - | NPPES |
Provider Name | Brandon K Bliss |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1720167752 PECOS PAC ID: 7113926049 Enrollment ID: I20061204000233 |
Provider Name | Kimball R Taylor |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1437383890 PECOS PAC ID: 1153472733 Enrollment ID: I20090622000092 |
Provider Name | Mark H Peterson |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1528089224 PECOS PAC ID: 7214104579 Enrollment ID: I20120127000202 |
Provider Name | Rogan L Taylor |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1356333611 PECOS PAC ID: 8022047075 Enrollment ID: I20120207000850 |
Provider Name | Douglas Ashton |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1972900959 PECOS PAC ID: 3971814773 Enrollment ID: I20150718000019 |
Provider Name | Robert W Lund |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1598122657 PECOS PAC ID: 5890092381 Enrollment ID: I20160329000637 |
Provider Name | Samuel Mckay Lee |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1518604370 PECOS PAC ID: 5193103091 Enrollment ID: I20220606001556 |
Provider Name | Chandler J Birks |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1447935515 PECOS PAC ID: 6204296999 Enrollment ID: I20230712004522 |
Provider Name | Trevor M Cannon |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1649959552 PECOS PAC ID: 7315309317 Enrollment ID: I20230808001460 |
Provider Name | Ryan E Pinckney |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1336914217 PECOS PAC ID: 8921451402 Enrollment ID: I20240131003860 |
Provider Name | Andrew Jimin Gottfredson |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1861230922 PECOS PAC ID: 8426594391 Enrollment ID: I20240726003822 |
Mailing Address | Practice Location Address |
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9070 W Cheyenne Ave Ste 100, Las Vegas, NV 89129-8935 Ph: (702) 268-7213 | 3303 N University Ave, Provo, UT 84604-4438 Ph: (801) 373-7438 |