Healthcare Provider Details

I. General information

NPI: 1598998973
Provider Name (Legal Business Name): SOUTH CENTRAL THERAPIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 N STATE ST
SALINA UT
84654-1363
US

IV. Provider business mailing address

45 N STATE ST
SALINA UT
84654-1363
US

V. Phone/Fax

Practice location:
  • Phone: 435-529-2234
  • Fax: 435-529-2236
Mailing address:
  • Phone: 435-529-2234
  • Fax: 435-529-2236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number121523-2401
License Number StateUT

VIII. Authorized Official

Name: DANIEL J BRUSE
Title or Position: PHYSICAL THERAPIST OWNER
Credential: P.T.
Phone: 435-529-2234