Provider Demographics
NPI:1770037798
Name:HOUSE CALL PHYSICAL THERAPY
Entity Type:Organization
Organization Name:HOUSE CALL PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:435-749-1852
Mailing Address - Street 1:3143 S 840 E
Mailing Address - Street 2:STE 327
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8491
Mailing Address - Country:US
Mailing Address - Phone:435-749-1852
Mailing Address - Fax:
Practice Address - Street 1:3143 S 840 E
Practice Address - Street 2:STE 327
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8491
Practice Address - Country:US
Practice Address - Phone:435-749-1852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9801659-2401261QP2000X
NV2557261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy