Healthcare Provider Details

I. General information

NPI: 1194121350
Provider Name (Legal Business Name): AARON AUSTIN HARWARD PT DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 09/19/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 E RIVERSIDE DR STE 303
ST GEORGE UT
84790-8722
US

IV. Provider business mailing address

340 FALCON RIDGE PKWY #500
MESQUITE NV
89027-8850
US

V. Phone/Fax

Practice location:
  • Phone: 435-673-4303
  • Fax: 435-673-4003
Mailing address:
  • Phone: 702-346-3105
  • Fax: 702-346-3544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number9602025-2401
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3065
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: