Provider Demographics
NPI:1003099631
Name:SAVAGE, NATHAN JAMES (MS, PT, COMT)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:JAMES
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:MS, PT, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 E 400 N
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-1944
Mailing Address - Country:US
Mailing Address - Phone:801-633-3235
Mailing Address - Fax:
Practice Address - Street 1:725 E 400 N
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-1944
Practice Address - Country:US
Practice Address - Phone:801-633-3235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4739584-24012251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical