Healthcare Provider Details

I. General information

NPI: 1427458256
Provider Name (Legal Business Name): SUMMIT REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 E 1450 S
SAINT GEORGE UT
84790-6124
US

IV. Provider business mailing address

1532 E 1450 S
SAINT GEORGE UT
84790-6124
US

V. Phone/Fax

Practice location:
  • Phone: 435-628-5150
  • Fax: 435-656-5150
Mailing address:
  • Phone: 435-628-5150
  • Fax: 435-656-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DARRIN M HURDSMAN
Title or Position: MANAGER
Credential: OTR/L, CLT-LANA
Phone: 435-414-4750