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General NPI Number Information
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NPI Number | 1275731291
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Entity Type | Organization
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Legal Business Name | SUNSET PHYSICAL THERAPY, L.L.C.
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 1812 W SUNSET BLVD STE 17
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City | SAINT GEORGE
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State | UT
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Zip | 84770-6606
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Country | US
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Telephone | 435-229-9929
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Fax |
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Provider Business Mailing Address
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Address Line | 1386 MAJESTIC DR
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City | WASHINGTON
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State | UT
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Zip | 84780-2345
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Country | US
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Telephone | 435-229-9929
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Fax | 435-986-1037
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Authorized Official
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Title or Position | OWNER-MEMBER
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Name | LOUIE DOYLE BURT
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Credential | M.S., P.T.
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Telephone | 435-229-9929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 347017-2401
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License Number State | UT
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