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NPI Code Detail

MEDICARE: WEBB PHYSICAL THERAPY INC.

MEDICARE: WEBB PHYSICAL THERAPY INC.
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 Therapist120650-2401UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
252783656808001OTHERUTBCBS TRAD. PROVIDER #
3TPRA10491OTHERUTMOLINA PROVIDER #
452783656808001OTHERUTBCBS FED. PROVIDER #
5577514OTHERUTDMBA PROVIDER #

General Provider Information

NPI Number : 1689627564
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEBB PHYSICAL THERAPY INC.
Provider Business Mailing Address
First Line : 1452 E RIDGELINE DR
Second Line : #51
City : SOUTH OGDEN
State : UT
Zip : 84405-4946
Country : US
Telephone Number : 801-479-5777
Fax Number : 801-479-7005
Provider Business Practice Location Address
First Line : 1452 E RIDGELINE DR
Second Line : #51
City : SOUTH OGDEN
State : UT
Zip : 84405-4946
Country : US
Telephone Number : 801-479-5777
Fax Number : 801-479-7005
Authorized Official
Title or Position : PRESIDENT
Name : BRENT WEBB
Credential :
Telephone Number : 801-479-5777
Provider Enumeration Date : 05/19/2006
Last Update Date : 08/22/2020

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Directions to “WEBB PHYSICAL THERAPY INC. ” Practice Location

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