Jonathan Patrick Sprouse, | |
190 S Highway 165, Providence, UT 84332-9512 | |
(435) 755-3300 | |
Not Available |
Full Name | Jonathan Patrick Sprouse |
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Gender | Male |
Speciality | Physical Therapist |
Location | 190 S Highway 165, Providence, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548953631 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 13286986-2401 (Utah) | Primary |
Provider Name | Ihc Health Services Inc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1033822085 PECOS PAC ID: 1850209420 Enrollment ID: O20230627000064 |
Mailing Address | Practice Location Address |
---|---|
Jonathan Patrick Sprouse, 1007 E 450 N, Heber City, UT 84032-3089 Ph: (435) 671-7854 | Jonathan Patrick Sprouse, 190 S Highway 165, Providence, UT 84332-9512 Ph: (435) 755-3300 |
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 | |
Katelyn Laaksonen, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 550 W 465 N Ste 504, Providence, UT 84332 Phone: 435-535-3677 | |
Gateway Physical Therapy And Sports Rehab Physical Therapist Medicare: Medicare Enrolled Practice Location: 169 N Gateway Dr Ste 160, Providence, UT 84332 Phone: 435-799-3111 | |
Michael Taylor, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 267 N Spring Creek Pkwy, Providence, UT 84332 Phone: 435-792-9400 | |
Martin Lee Anderson, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 169 Springcreek Pkwy, Providence, UT 84332 Phone: 435-755-8500 Fax: 435-755-2836 | |
Mr. John W Payne, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 169 N Gateway Dr Ste 210, Providence, UT 84332 Phone: 435-701-7010 Fax: 435-701-7012 |