Provider Demographics
NPI:1942376215
Name:SZPUNAR, VAL (PT)
Entity Type:Individual
Prefix:MR
First Name:VAL
Middle Name:
Last Name:SZPUNAR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 N 1220 E
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-4918
Mailing Address - Country:US
Mailing Address - Phone:435-757-0786
Mailing Address - Fax:435-787-2862
Practice Address - Street 1:77 N 1220 E
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-4918
Practice Address - Country:US
Practice Address - Phone:435-757-0786
Practice Address - Fax:435-787-2862
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT380228-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT38022824000001OtherREGENCE BCBS
UTQ63586Medicare UPIN