Healthcare Provider Details

I. General information

NPI: 1891214359
Provider Name (Legal Business Name): DANIEL SANDBERG DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2017
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W 4800 S STE 31
MURRAY UT
84107-3700
US

IV. Provider business mailing address

4704 S DUTCH HOLLOW LN # 805
MILLCREEK UT
84117-5895
US

V. Phone/Fax

Practice location:
  • Phone: 385-743-9111
  • Fax:
Mailing address:
  • Phone: 385-743-9111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10246788-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: