Provider Demographics
NPI:1689148454
Name:BARNETT, SARGENT DOIL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SARGENT
Middle Name:DOIL
Last Name:BARNETT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 N 300 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-6124
Mailing Address - Country:US
Mailing Address - Phone:801-357-1250
Mailing Address - Fax:
Practice Address - Street 1:822 TURF FARM RD UNIT 3
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-5797
Practice Address - Country:US
Practice Address - Phone:801-357-2860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11087472-24012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic