Provider Demographics
NPI:1245243864
Name:FEIG, JOHN W (RPT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:W
Last Name:FEIG
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 71403
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84171-0403
Mailing Address - Country:US
Mailing Address - Phone:801-944-1209
Mailing Address - Fax:801-944-8994
Practice Address - Street 1:7350 WASATCH BLVD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-4627
Practice Address - Country:US
Practice Address - Phone:801-944-1209
Practice Address - Fax:801-944-8994
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT92-1216002401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTS15845Medicare UPIN