Provider Demographics
NPI:1033210067
Name:GUBLER, TROY CAL (MPT)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:CAL
Last Name:GUBLER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 S 2600 W, STE 201
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737-3270
Mailing Address - Country:US
Mailing Address - Phone:435-635-9333
Mailing Address - Fax:435-635-3026
Practice Address - Street 1:83 S 2600 W
Practice Address - Street 2:STE 201
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-3266
Practice Address - Country:US
Practice Address - Phone:435-635-9333
Practice Address - Fax:435-635-3026
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT942705232401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000063763OtherMEDICARE PTAN
UT270523-2401OtherSTATE OF UTAH P.T. LICENSE NUMBER
UT000063763OtherMEDICARE PTAN