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NPI Code Detail

MEDICARE: LACY SCHIWAL PT

MEDICARE: LACY SCHIWAL PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist62152332401UT

General Provider Information

NPI Number : 1669682696
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACY SCHIWAL PT
Provider Business Mailing Address
First Line : 1380 E MEDICAL CENTER DR
Second Line :
City : SAINT GEORGE
State : UT
Zip : 84790-2123
Country : US
Telephone Number : 435-251-1000
Fax Number : 435-688-5514
Provider Business Practice Location Address
First Line : 1380 E MEDICAL CENTER DR
Second Line :
City : SAINT GEORGE
State : UT
Zip : 84790-2123
Country : US
Telephone Number : 435-251-1000
Fax Number : 435-688-5514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 07/08/2007

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Directions to “ LACY SCHIWAL PT” Practice Location

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