Healthcare Provider Details

I. General information

NPI: 1861406514
Provider Name (Legal Business Name): DANIEL JOSEPH BRUSE P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 S STATE ST
SALINA UT
84654-1345
US

IV. Provider business mailing address

190 S STATE ST
SALINA UT
84654-1345
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:
Title or Position:
Credential:
Phone: