| Jacob Proffit, DPT, ATC | |
|
209 W 300 N, Logan, UT 84321-3809 | |
| (435) 716-8535 | |
| Not Available |
| Full Name | Jacob Proffit |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 3 Years |
| Location | 209 W 300 N, Logan, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154185148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 11965771-2401 (Utah) | Primary |
| 2255A2300X | Specialist/technologist - Athletic Trainer | 11965771-4810 (Utah) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wasatch Therapy Inc | 3476524760 | 10 |
| Provider Name | Wasatch Therapy Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1780894485 PECOS PAC ID: 3476524760 Enrollment ID: O20040802000797 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Proffit, DPT, ATC 9195 N 6400 W, Tremonton, UT 84337-8603 Ph: (425) 512-2951 | Jacob Proffit, DPT, ATC 209 W 300 N, Logan, UT 84321-3809 Ph: (435) 716-8535 |
Shaun P Dahle, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1400 N 500 E, Logan, UT 84341 Phone: 435-716-6440 |
Brandon David Greenwood, PT Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 1400 N 500 E, Logan, UT 84341 Phone: 435-716-1000 |
Madison Spainhower, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 209 W 300 N, Logan, UT 84321 Phone: 435-716-8535 |
Kyle Cameron Johnson, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2310 N 400 E Ste B, Logan, UT 84341 Phone: 435-774-8557 |
Mrs. Grace Lords, PT,DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1300 N 500 E, Logan, UT 84341 Phone: 435-716-2880 |
Sarah C Sievers, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1400 N 500 E, Logan, UT 84341 Phone: 435-755-3360 |
Brent Rawlings, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 630 E 1400 N Ste 140, Logan, UT 84341 Phone: 435-213-3850 Fax: 435-213-9576 |