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General NPI Number Information
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NPI Number | 1902946379
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Entity Type | Organization
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Legal Business Name | FIT QUEST THERAPY & REHABILITATION INC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 2120 N 400 E
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City | NORTH OGDEN
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State | UT
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Zip | 84414-7238
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Country | US
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Telephone | 801-782-3500
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Fax | 801-786-1926
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Provider Business Mailing Address
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Address Line | 2120 N 400 E
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City | NORTH OGDEN
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State | UT
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Zip | 84414-7238
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Country | US
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Telephone | 801-782-3500
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Fax | 801-786-1926
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Authorized Official
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Title or Position | OFFICER
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Name | KENNETH D COLLEDGE
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Credential | RPT
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Telephone | 801-668-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 103041-2401
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License Number State | UT
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