| Mrs Camille Lider, DPT | |
|
3476 W 4600 S, West Haven, UT 84401 | |
| (801) 689-0200 | |
| (801) 689-0201 |
| Full Name | Mrs Camille Lider |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 3476 W 4600 S, West Haven, Utah |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801142518 | NPI | - | NPPES |
| 1801142518 | Other | NPI | |
| 10789141-2401 | Other | UT | UTAH DOPL PT LICENSE |
| 12756913 | Other | CAQH | |
| 3008026 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 10789141-2401 (Utah) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Camille Lider, DPT 3476 W 4600 S, West Haven, UT 84401 Ph: (801) 689-0200 | Mrs Camille Lider, DPT 3476 W 4600 S, West Haven, UT 84401 Ph: (801) 689-0200 |
Jasmine Brown, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3476 W 4600 S, West Haven, UT 84401 Phone: 801-689-0200 | |
Kyle A Knop, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3476 W 4600 S, West Haven, UT 84401 Phone: 801-689-0200 Fax: 801-689-0201 | |
Garrett Hardy Jones, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3476 W 4600 S, West Haven, UT 84401 Phone: 801-689-0200 Fax: 801-689-0201 | |
Mr. Dennis Tracy Gilbert, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4607 Midland Dr, Suit 201, West Haven, UT 84401 Phone: 801-732-8700 Fax: 801-732-2103 | |
Chad Jeffrey Tenney, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3476 W 4600 S, West Haven, UT 84401 Phone: 801-689-0200 Fax: 801-689-0201 | |
Justin Denis Longhurst, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4640 S 3500 W, Suite 3, West Haven, UT 84401 Phone: 801-689-0200 Fax: 801-689-0201 | |
Mitch Lillywhite, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4640 S 3500 W, West Haven, UT 84401 Phone: 801-689-0200 |