| Delta Physical Therapy And Sports | |
|
95 White Sage Ave, Suite C, Delta, UT 84624-5555 | |
| (435) 864-2551 | |
| (435) 864-3573 |
| Full Name | Delta Physical Therapy And Sports |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 95 White Sage Ave, Delta, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801834700 | NPI | - | NPPES |
| 1669788725 | Medicaid | UT | |
| 529299099026 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 285712-2401 (Utah) | Primary |
| 225X00000X | Occupational Therapist | 5530573-4201 (Utah) | Secondary |
| Provider Name | Louis Howard Quackenbush |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487780003 PECOS PAC ID: 1850292285 Enrollment ID: I20040127000421 |
| Provider Name | Randy D Stinson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669788725 PECOS PAC ID: 3375732068 Enrollment ID: I20110111000913 |
| Provider Name | Scott R Allen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467865840 PECOS PAC ID: 4486931086 Enrollment ID: I20170509001641 |
| Provider Name | Andrew M Wankier |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235634569 PECOS PAC ID: 7315290053 Enrollment ID: I20181027000036 |
| Provider Name | Dustin Kunz |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1235779224 PECOS PAC ID: 9931538337 Enrollment ID: I20200407000222 |
| Provider Name | Katy Glenn Roper |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1477162048 PECOS PAC ID: 9739506080 Enrollment ID: I20200901001062 |
| Provider Name | Mylisa Jacobson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1245980176 PECOS PAC ID: 4284020645 Enrollment ID: I20220412000532 |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Physical Therapy And Sports 95 White Sage Ave, Suite C, Delta, UT 84624-5555 Ph: (435) 864-2551 | Delta Physical Therapy And Sports 95 White Sage Ave, Suite C, Delta, UT 84624-5555 Ph: (435) 864-2551 |
Dr. Andrew Wankier, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 95 White Sage Ave Ste C, Delta, UT 84624 Phone: 435-864-2551 | |
Dustin Kunz, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 95 White Sage Ave Ste C, Delta, UT 84624 Phone: 435-864-2551 Fax: 435-864-3573 | |
Dr. Louis Howard Quackenbush Ii, D.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 95 White Sage Ave, Suite C, Delta, UT 84624 Phone: 435-864-2551 Fax: 435-864-3573 | |
Mr. Randy Dale Stinson, D.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 95 White Sage Ave Ste C, Delta, UT 84624 Phone: 435-864-2551 Fax: 435-864-3573 | |
Mr. Chad Rand Crafts, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 95 White Sage Ave, Delta, UT 84624 Phone: 435-864-2551 Fax: 435-864-3573 |