Provider Demographics
NPI:1790976660
Name:GLAD TIDINGS, LLC
Entity Type:Organization
Organization Name:GLAD TIDINGS, LLC
Other - Org Name:MOBILE OUTPATIENT PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:III
Authorized Official - Credentials:PT
Authorized Official - Phone:801-787-7341
Mailing Address - Street 1:462 RIVER CROSS RD
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-4613
Mailing Address - Country:US
Mailing Address - Phone:801-787-7341
Mailing Address - Fax:801-804-6748
Practice Address - Street 1:462 RIVER CROSS RD
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-4613
Practice Address - Country:US
Practice Address - Phone:801-471-8936
Practice Address - Fax:801-804-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3443262401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty