Provider Demographics
NPI:1710455381
Name:DANIELS THERAPY SERVICES
Entity Type:Organization
Organization Name:DANIELS THERAPY SERVICES
Other - Org Name:DANIELS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:KOLBY
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, PT
Authorized Official - Phone:435-652-3707
Mailing Address - Street 1:1664 S DIXIE DR STE L105
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-7331
Mailing Address - Country:US
Mailing Address - Phone:435-652-3707
Mailing Address - Fax:435-652-3750
Practice Address - Street 1:1664 S DIXIE DR STE L105
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-7331
Practice Address - Country:US
Practice Address - Phone:435-652-3707
Practice Address - Fax:435-652-3750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1366452880Medicaid