Healthcare Provider Details

I. General information

NPI: 1376754929
Provider Name (Legal Business Name): PRECISION REHABILITATION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 S 200 W
BLANDING UT
84511-3910
US

IV. Provider business mailing address

PO BOX 745
BLANDING UT
84511-0745
US

V. Phone/Fax

Practice location:
  • Phone: 435-678-3869
  • Fax: 435-678-3769
Mailing address:
  • Phone: 435-678-3869
  • Fax: 435-678-3769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5009456-4201
License Number StateUT
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number327198-2401
License Number StateUT

VIII. Authorized Official

Name: MR. RICHARD T WARD
Title or Position: PRESIDENT
Credential: PT
Phone: 435-979-2742