Intermountain Healthcare

Organization Active NPI Physical Therapy Clinic/Center · Riverton, UT

NPI 1114378288 · NPPES record last updated Jun 29, 2016

Key facts

NPI
1114378288
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapy Clinic/Center 261QP2000X
License
9811303-8016 (UT)
Legal business name
INTERMOUNTAIN HEALTHCARE
Practice address
3741 W 12600 S
Riverton, UT 84065-7215
Phone
(801) 285-3400
NPI assigned
Jun 29, 2016
Organization subpart
No

Authorized official

Name
Pam Dibblee, DPT
Title
DPT, Clinic Manager
Phone
(801) 285-3400

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Bradley S Thompson DO (479 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 9811303-8016 UT Yes

Addresses

Primary practice location

3741 W 12600 S
Riverton, UT 84065-7215

Mailing address

3741 W 12600 S
Riverton, UT 84065-7215
Phone (801) 285-3400

Other providers in Riverton, UT

All providers in Riverton, UT · Physical Therapy Clinic/Center in Utah

Sources for this page

Verify at the official NPI Registry.