Healthcare Provider Details

I. General information

NPI: 1164365722
Provider Name (Legal Business Name): RED MESA MOBILITY PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 N 1680 E
ST GEORGE UT
84790-2500
US

IV. Provider business mailing address

1597 S RIPPLE ROCK DR
WASHINGTON UT
84780-3685
US

V. Phone/Fax

Practice location:
  • Phone: 719-688-1345
  • Fax:
Mailing address:
  • Phone: 719-688-1345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. NICHOLAS R DURST
Title or Position: MANAGING MEMBER
Credential: DPT
Phone: 719-688-1345