Provider Demographics
NPI:1922775725
Name:KOHLER, JEFF
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:KOHLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3271 S PECOS DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-3444
Mailing Address - Country:US
Mailing Address - Phone:435-773-7039
Mailing Address - Fax:
Practice Address - Street 1:3271 S PECOS DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-3444
Practice Address - Country:US
Practice Address - Phone:435-773-7039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant