Healthcare Provider Details

I. General information

NPI: 1548148810
Provider Name (Legal Business Name): ROBBY WAYNE DILG DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 S MEDICAL DR STE B
BRIGHAM CITY UT
84302-3119
US

IV. Provider business mailing address

1030 S MEDICAL DR STE B
BRIGHAM CITY UT
84302-3119
US

V. Phone/Fax

Practice location:
  • Phone: 435-538-5111
  • Fax: 435-538-5981
Mailing address:
  • Phone: 435-538-5111
  • Fax: 435-538-5981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number142377062401
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number14237706-2401
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number14237706-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: