Adam Boyd Webb, PT
Individual provider Active NPI Physical Therapist · Ivins, UT
NPI 1720180599 · NPPES record last updated Jun 12, 2012
Key facts
- NPI
- 1720180599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 52730712401 (UT)
- Practice address
- 272 E Center St
Suite 103
Ivins, UT 84738-6456 - Phone
- (435) 674-2115
- Fax
- (435) 673-7711
- NPI assigned
- Sep 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52730712401 | UT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain Land Outpatient Services | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 52730712401 | UT | Yes |
Addresses
Primary practice location
272 E Center St
Suite 103
Ivins, UT 84738-6456
Mailing address
PO Box 711185
Salt Lake City, UT 84171
Phone (801) 942-3311
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720180599 | Medicaid | UT |
Other providers in Ivins, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2012. 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.