Provider Demographics
NPI:1215776018
Name:SAUNDERS, KORTNEE (PTA)
Entity type:Individual
Prefix:
First Name:KORTNEE
Middle Name:
Last Name:SAUNDERS
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 1:1831 N 3375 W
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84404-9139
Mailing Address - Country:US
Mailing Address - Phone:801-497-6283
Mailing Address - Fax:
Practice Address - Street 1:4617 S PIONEER RD STE 103
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5156
Practice Address - Country:US
Practice Address - Phone:435-767-9096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13958008-2402225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant