Provider Demographics
NPI:1235482977
Name:WASATCH THERAPY INC
Entity Type:Organization
Organization Name:WASATCH THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ARLENE
Authorized Official - Last Name:ITA'AEHAU
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:801-479-9865
Mailing Address - Street 1:5349 ADAMS AVE PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-4736
Mailing Address - Country:US
Mailing Address - Phone:801-479-9865
Mailing Address - Fax:801-479-5846
Practice Address - Street 1:1916 N 700 W STE 240
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5864
Practice Address - Country:US
Practice Address - Phone:801-784-7373
Practice Address - Fax:801-784-7532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy