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NPI Code Detail

MEDICARE: SCOTT R LABRUM PT

MEDICARE:   SCOTT R LABRUM  PT
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 Therapist350512-2401UT

General Provider Information

NPI Number : 1457343725
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT R LABRUM PT
Provider Business Mailing Address
First Line : PO BOX 933
Second Line :
City : PRICE
State : UT
Zip : 84501-0933
Country : US
Telephone Number : 435-613-1500
Fax Number : 435-613-1501
Provider Business Practice Location Address
First Line : 150 E MAIN ST
Second Line :
City : CASTLE DALE
State : UT
Zip : 84513
Country : US
Telephone Number : 435-381-5100
Fax Number : 435-381-5099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 05/11/2015

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Directions to “ SCOTT R LABRUM PT” Practice Location

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