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General NPI Number Information
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NPI Number | 1114715935
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Entity Type | Organization
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Legal Business Name | PROOF PHYSIOTHERAPY LLC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 4386 W MONUMENT PEAK DR
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City | HERRIMAN
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State | UT
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Zip | 84096
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Country | US
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Telephone | 801-450-0008
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Fax |
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Provider Business Mailing Address
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Address Line | 4386 W MONUMENT PEAK DR
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City | HERRIMAN
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State | UT
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Zip | 84096
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Country | US
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Telephone | 801-450-0008
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Fax |
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Authorized Official
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Title or Position | PT
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Name | JASON DANIELSON
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Credential | PT, DPT
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Telephone | 801-450-0008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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