Haden Bunderson
Individual provider Active NPI Physical Therapist · Vernal, UT
NPI 1093590184 · NPPES record last updated Aug 28, 2023
Key facts
- NPI
- 1093590184
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 150 W 100 N
Vernal, UT 84078-2036 - Phone
- (435) 789-6757
- NPI assigned
- Aug 28, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
150 W 100 N
Vernal, UT 84078-2036
Mailing address
150 W 100 N
Vernal, UT 84078-2036
Other providers in Vernal, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.