David Von Niederhausern
Individual provider Active NPI Physical Therapy Assistant · Hyde Park, UT
NPI 1881077360 · NPPES record last updated Jul 2, 2015
Key facts
- NPI
- 1881077360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 282567-2402 (UT)
- Practice address
- 330 Park Meadow Cir
Hyde Park, UT 84318-3804 - Phone
- (435) 760-3060
- NPI assigned
- Jul 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 282567-2402 | UT | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 282567-2402 | UT | Yes |
Addresses
Primary practice location
330 Park Meadow Cir
Hyde Park, UT 84318-3804
Mailing address
330 Park Meadow Cir.
Hyde Park, UT 84318
Other providers in Hyde Park, UT
- McKayla M Ross
- Nicole Jean Sadler
- Andrea Lee Skates
- Summit Psychiatry LLC
- Terry P. Barnes, Ms, P.C.
- White Oak Wellness PLLC
- Whole Body Health Care PLLC
All providers in Hyde Park, UT · Physical Therapy Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2015. 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.