MEDICARE: NEW PARADIGM PHYSICAL THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1073345617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW PARADIGM PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	699 E SOUTH TEMPLE STE 260
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-4258
Country	:	US
Telephone Number	:	801-641-4661
Fax Number	:

Provider Business Practice Location Address
First Line	:	699 E SOUTH TEMPLE STE 260
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-4258
Country	:	US
Telephone Number	:	801-641-4661
Fax Number	:

Authorized Official
Title or Position	:	CLINIC MANAGER
Name	:	MISS JULIE LYNN WALDO
Credential	:	MPT
Telephone Number	:	801-641-4661

Provider Enumeration Date	:	08/14/2024
Last Update Date	:	08/14/2024

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Directions to “NEW PARADIGM PHYSICAL THERAPY ” Practice Location

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