Healthcare Provider Details

I. General information

NPI: 1184588790
Provider Name (Legal Business Name): WILLIAM DANIEL WHALEN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 N STATE ST
OREM UT
84057-2057
US

IV. Provider business mailing address

575 W 1000 N
PLEASANT GROVE UT
84062-1667
US

V. Phone/Fax

Practice location:
  • Phone: 801-494-2020
  • Fax:
Mailing address:
  • Phone: 801-687-3066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11791398-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: