Healthcare Provider Details

I. General information

NPI: 1871577494
Provider Name (Legal Business Name): DAVID ELI HAWKINS M.S.P.T
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 S 1300 W
PLEASANT GROVE UT
84062-3761
US

IV. Provider business mailing address

17235 N 75TH AVE STE E145
GLENDALE AZ
85308-0867
US

V. Phone/Fax

Practice location:
  • Phone: 385-440-1400
  • Fax: 801-845-9965
Mailing address:
  • Phone: 623-201-7210
  • Fax: 623-201-7214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1466
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11871200-2401
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8768
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: