Provider Demographics
NPI:1831654656
Name:STEPUP PHYSICAL THERAPY
Entity Type:Organization
Organization Name:STEPUP PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:REANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-792-9189
Mailing Address - Street 1:746 E WINCHESTER ST STE G10
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-8532
Mailing Address - Country:US
Mailing Address - Phone:801-981-5977
Mailing Address - Fax:801-839-9170
Practice Address - Street 1:746 E WINCHESTER ST STE G10
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-8532
Practice Address - Country:US
Practice Address - Phone:801-981-5977
Practice Address - Fax:801-839-9170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty