NPI 1336753565 · live from the CMS NPI Registry
Back At Work Of Utah LLC
Physical Therapist in Logan, UT. National Provider Identifier 1336753565, active.
NPI record
| NPI | 1336753565 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 630 E 1400 N Ste 140, Logan, UT 84341 |
| Practice phone | 435-213-3850 |
| Mailing address | 1200 Corporate Dr Ste 400, Hoover, AL 35242 |
| Enumerated | September 4, 2020 |
| Last updated | September 18, 2020 |
| Authorized official | Bryan Barganier, Cfo |
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.