Alpine Physical Therapy LLC
Organization Active NPI Physical Therapy Clinic/Center · Alpine, UT
NPI 1194965665 · NPPES record last updated Apr 7, 2009
Key facts
- NPI
- 1194965665
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- 4777580-2401 (UT)
- Legal business name
- ALPINE PHYSICAL THERAPY LLC
- Practice address
- 75 W Main Street CT Ste 100
Alpine, UT 84004-5602 - Phone
- (801) 216-4299
- Fax
- (801) 216-4298
- NPI assigned
- Feb 24, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Paul D Anderson, MPT
- Title
- Physical Therapist/Owner
- Phone
- (801) 216-4299
Practitioners 4
-
Paul D. Anderson, MPT
-
Connor Knuckles, LMT
-
Sarah Wilson, LMT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090504000133 | UT | Part B Supplier - Clinic/Group Practice | 7719035609 |
Receives reassigned benefits from 1 practitioner Practice locations: Alpine, UT |
National Provider Directory
Locations
75 W Main Street Ct
Ste 100
Alpine, UT 84004
Phone (801) 216-4298
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 4777580-2401 | UT | Yes |
Addresses
Primary practice location
75 W Main Street CT Ste 100
Alpine, UT 84004-5602
Mailing address
75 W Main Street CT
Suite #100
Alpine, UT 84004-5602
Phone (801) 216-4299
Other providers in Alpine, UT
- Alpine Dentistry
- Alpine Dentists and Specialists PLLC
- Alpine Dermatology PC
- Alpine Family Medicine LLC
- Alpine Recovery Lodge LLC
- Alpine Recovery Lodge LLC
- Chris Donald Anderson
- Paul D. Anderson
- Douglas Whitney Ashton
All providers in Alpine, UT · Physical Therapy Clinic/Center in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.