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NPI Code Detail

MEDICARE: MOUNTAIN LAND REHABILITATION LLC

MEDICARE: MOUNTAIN LAND REHABILITATION LLC
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
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1265549372
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOUNTAIN LAND REHABILITATION LLC
Provider Business Mailing Address
First Line : PO BOX 711185
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84171-1185
Country : US
Telephone Number : 801-942-3311
Fax Number : 801-942-5955
Provider Business Practice Location Address
First Line : 1952 E 7000 S
Second Line : SUITE 100
City : SALT LAKE CITY
State : UT
Zip : 84121-6878
Country : US
Telephone Number : 801-942-3311
Fax Number : 801-942-5955
Authorized Official
Title or Position : CHIEF REVENUE OFFICER
Name : COURTNEY LISZKA
Credential :
Telephone Number : 801-942-3311
Provider Enumeration Date : 08/24/2006
Last Update Date : 08/12/2025

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1962535534 — SARAH C JACKSON
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1912031691 — CATHERINE J SCHWAEGLER
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1982728598 — MEGAN C HANRAHAN
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Directions to “MOUNTAIN LAND REHABILITATION LLC ” 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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