| 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 |
|---|---|
| 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 |
|---|---|---|---|
| 1275098998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Stephen Kyle Severe |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114110079 PECOS PAC ID: 7810322591 Enrollment ID: I20200128000813 |
| Provider Name | Camille Porter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881920403 PECOS PAC ID: 7416136528 Enrollment ID: I20210324003401 |
| Provider Name | Isaac Malone |
|---|---|
| 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 |
|---|---|
| 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 | |
Katelyn Laaksonen, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 550 W 465 N Ste 504, Providence, UT 84332 Phone: 435-535-3677 | |
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 | |
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 |