NPI 1063429793 · live from the CMS NPI Registry
Amv Mountain Land Lc
Physical Therapist in Kanab, UT. National Provider Identifier 1063429793, active.
NPI record
| NPI | 1063429793 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 355 N Main St, Kanab, UT 84741 |
| Practice phone | 435-644-4199 |
| Mailing address | Po Box 711185, Salt Lake City, UT 84171 |
| Enumerated | August 2, 2006 |
| Last updated | June 16, 2008 |
| Authorized official | Mark Anderson, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Therapist | 225X00000X | — |
| Physical Therapist primary | 225100000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.