Provider Demographics
NPI:1619467198
Name:HIGH MOUNTAIN PHYSICAL THERAPY AND PERFORMANCE, LLC
Entity Type:Organization
Organization Name:HIGH MOUNTAIN PHYSICAL THERAPY AND PERFORMANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:435-708-1923
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:HATCH
Mailing Address - State:UT
Mailing Address - Zip Code:84735-0457
Mailing Address - Country:US
Mailing Address - Phone:435-708-1923
Mailing Address - Fax:
Practice Address - Street 1:60 E 100 S
Practice Address - Street 2:
Practice Address - City:HATCH
Practice Address - State:UT
Practice Address - Zip Code:84735-7786
Practice Address - Country:US
Practice Address - Phone:385-275-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy