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NPI Code Detail

MEDICARE: FOUNDATION PHYSICAL THERAPY

MEDICARE: FOUNDATION 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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1194318907
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOUNDATION PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 1628 W 11010 S STE 101
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-1278
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1628 W 11010 S STE 101
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-1278
Country : US
Telephone Number : 801-419-1196
Fax Number :
Authorized Official
Title or Position : CEO
Name : BRADLEY JAMES POWELL
Credential : DPT
Telephone Number : 801-419-1196
Provider Enumeration Date : 02/12/2021
Last Update Date : 03/30/2026

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Directions to “FOUNDATION PHYSICAL THERAPY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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