Provider Demographics
NPI:1922540707
Name:GUBLER, TORY ANN (PTA)
Entity Type:Individual
Prefix:
First Name:TORY
Middle Name:ANN
Last Name:GUBLER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 SOUTH 2600 WEST SUITE 201
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737
Mailing Address - Country:US
Mailing Address - Phone:435-635-9333
Mailing Address - Fax:435-635-3026
Practice Address - Street 1:83 SOUTH 2600 WEST SUITE 201
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737
Practice Address - Country:US
Practice Address - Phone:435-635-9333
Practice Address - Fax:435-635-3026
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9809758-8019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant