Healthcare Provider Details

I. General information

NPI: 1225952914
Provider Name (Legal Business Name): AXIS PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 N REDWOOD RD STE 200
NORTH SALT LAKE UT
84054
US

IV. Provider business mailing address

691 N REDWOOD RD STE 200
NORTH SALT LAKE UT
84054
US

V. Phone/Fax

Practice location:
  • Phone: 801-897-8444
  • Fax:
Mailing address:
  • Phone: 801-897-8444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. MEGAN MOSS
Title or Position: OWNER
Credential: DPT
Phone: 801-897-8444