Healthcare Provider Details

I. General information

NPI: 1629527130
Provider Name (Legal Business Name): GALE MCCALL PT, DPT, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2016
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 E WADSWORTH PARK DR STE 230
DRAPER UT
84020-8096
US

IV. Provider business mailing address

65 E WADSWORTH PARK DR STE 230
DRAPER UT
84020-8096
US

V. Phone/Fax

Practice location:
  • Phone: 385-308-8034
  • Fax:
Mailing address:
  • Phone: 385-308-8034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8810
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1281442
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number23953
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305210722
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT012375
License Number StateGA
# 7
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP20104
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberLAT-4708
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: