Healthcare Provider Details

I. General information

NPI: 1639508633
Provider Name (Legal Business Name): UNITED THERAPY NETWORK INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2013
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 E TACHEVAH DR SUITE 107
PALM SPRINGS CA
92262-7401
US

IV. Provider business mailing address

1845 BUSINESS CENTER DR STE 127
SAN BERNARDINO CA
92408-3434
US

V. Phone/Fax

Practice location:
  • Phone: 760-459-0003
  • Fax: 760-656-0614
Mailing address:
  • Phone: 909-890-9030
  • Fax: 909-890-4393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: GUDMUNDUR HEIMIR GUNNARSSON
Title or Position: CEO
Credential: PT
Phone: 909-890-9030