Healthcare Provider Details
I. General information
NPI: 1487998431
Provider Name (Legal Business Name): UTAH PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/15/2012
Last Update Date: 09/02/2025
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3476 W 4600 S
WEST HAVEN UT
84401-9203
US
IV. Provider business mailing address
PO BOX 66
HOOPER UT
84315-0066
US
V. Phone/Fax
- Phone: 801-689-0200
- Fax: 801-689-0201
- Phone: 801-689-0200
- Fax: 801-689-0201
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
SARAH
J
TENNEY
Title or Position: OWNER, VP, COO, CFO
Credential: RN
Phone: 801-689-0200