Healthcare Provider Details
I. General information
NPI: 1215057617
Provider Name (Legal Business Name): DANIEL J MCATEE PA, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/30/2007
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1365 W 1000 N
SALT LAKE CITY UT
84116-1654
US
IV. Provider business mailing address
220 W 7200 S SUITE A
MIDVALE UT
84047-1043
US
V. Phone/Fax
- Phone: 801-328-5750
- Fax: 877-497-4661
- Phone: 801-858-3461
- Fax: 801-955-2389
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 368003-1206 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 368003-2401 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: