Proactive Physical Trerapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROACTIVE PHYSICAL TRERAPY LLC

Practice address

6095 S Fashion Blvd Ste 120
Murray, UT 84107-7383

Phone

(801) 210-0127

NPI assigned

Apr 20, 2026

Last updated

Apr 20, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Jacobson

Title

Coo

Phone

(503) 510-2536

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1417892225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6095 S FASHION BLVD STE 120",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6095 S FASHION BLVD STE 120",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077383",
            "telephone_number": "801-210-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL TRERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "503-510-2536"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Priedeman, LCSW
• Primary Healthcare, PLLC
• Shaon Primus
• Jessica Sydney Principe, MS, OTR/L
• Private Healthcare Facilities
• Kelsey Marie Probst, PA-C
• Spencer Proctor, M.D.
• Professional Employee Services (Disability Benefit Advocates)
• Progressive Eye Care, LLC (Classic Optical)
• Promind Psychiatry

• Physical Therapy Clinic/Center in Murray, UT
• Providers in Murray, UT by specialty
• Physical Therapy Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.