Provider Demographics
NPI:1598096083
Name:WASATCH PHYSICAL THERAPY & REHABILITATION, INC
Entity Type:Organization
Organization Name:WASATCH PHYSICAL THERAPY & REHABILITATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:C
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:801-713-0610
Mailing Address - Street 1:5323 WOODROW ST
Mailing Address - Street 2:#204
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5841
Mailing Address - Country:US
Mailing Address - Phone:801-713-0610
Mailing Address - Fax:801-713-0613
Practice Address - Street 1:823 E 400 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2903
Practice Address - Country:US
Practice Address - Phone:801-363-3918
Practice Address - Fax:801-596-3796
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WASATCH PHYSICAL THERAPY AND REHABILITATION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-22
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty