Healthcare Provider Details

I. General information

NPI: 1881515799
Provider Name (Legal Business Name): AUSTIN C EGBERT DPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

957 S STATE HIGHWAY 89 STE 150
LOGAN UT
84321-5572
US

IV. Provider business mailing address

1411 FALLS AVE E STE 401
TWIN FALLS ID
83301-3455
US

V. Phone/Fax

Practice location:
  • Phone: 435-554-1544
  • Fax: 435-214-0668
Mailing address:
  • Phone: 435-554-1544
  • Fax: 435-214-0668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14299853-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: