Gateway Physical Therapy And Sports Rehab | |
169 N Gateway Dr Ste 160, Providence, UT 84332-9707 | |
(435) 799-3111 | |
Not Available |
Full Name | Gateway Physical Therapy And Sports Rehab |
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Type | Facility |
Speciality | Physical Therapist |
Location | 169 N Gateway Dr Ste 160, Providence, Utah |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1275098998 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Stephen Kyle Severe |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1376074187 PECOS PAC ID: 4587931514 Enrollment ID: I20170523002369 |
Provider Name | Darin Andrew Chase |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1063550028 PECOS PAC ID: 6002241783 Enrollment ID: I20200128000724 |
Provider Name | Vernon Robert Malan |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1114110079 PECOS PAC ID: 7810322591 Enrollment ID: I20200128000813 |
Provider Name | Camille Porter |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1881920403 PECOS PAC ID: 7416136528 Enrollment ID: I20210324003401 |
Provider Name | Isaac Malone |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1487197125 PECOS PAC ID: 3274913736 Enrollment ID: I20220630002242 |
Mailing Address | Practice Location Address |
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Gateway Physical Therapy And Sports Rehab 169 N Gateway Dr Ste 160, Providence, UT 84332-9882 Ph: (435) 799-3111 | Gateway Physical Therapy And Sports Rehab 169 N Gateway Dr Ste 160, Providence, UT 84332-9707 Ph: (435) 799-3111 |
Darin Andrew Chase, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 169 N Gateway Dr Ste 160, Providence, UT 84332 Phone: 435-799-3111 Fax: 435-799-3148 | |
Brandon Reed, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 550 W 465 N, Providence, UT 84332 Phone: 435-535-3677 | |
Katelyn Laaksonen, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 550 W 465 N Ste 504, Providence, UT 84332 Phone: 435-535-3677 | |
Hunter Hanks, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 169 N Gateway Dr Ste 160, Providence, UT 84332 Phone: 435-799-3111 | |
Jonathan Patrick Sprouse, Physical Therapist Medicare: Medicare Enrolled Practice Location: 190 S Highway 165, Providence, UT 84332 Phone: 435-755-3300 | |
Michael Taylor, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 267 N Spring Creek Pkwy, Providence, UT 84332 Phone: 435-792-9400 |