| Orem Sports Medicine Center, Llc | |
|
980 E 800 N Ste 103, Orem, UT 84097-4261 | |
| (801) 226-0599 | |
| (801) 226-3145 |
| Full Name | Orem Sports Medicine Center, Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 980 E 800 N Ste 103, Orem, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659397313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 4739582-2401 (Utah) | Primary |
| Provider Name | Daniel R Lillywhite |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649437799 PECOS PAC ID: 1052481579 Enrollment ID: I20080610000122 |
| Provider Name | Matthew F Bushnell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033402607 PECOS PAC ID: 5496924714 Enrollment ID: I20110803000149 |
| Provider Name | Justin G Brown |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497279228 PECOS PAC ID: 1254605173 Enrollment ID: I20170915002022 |
| Provider Name | Zachery T Snow |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861031775 PECOS PAC ID: 7113354184 Enrollment ID: I20200304000715 |
| Provider Name | Regina J Espinoza |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255001947 PECOS PAC ID: 5890193940 Enrollment ID: I20211005000743 |
| Provider Name | Justin Roy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962140897 PECOS PAC ID: 4587047865 Enrollment ID: I20220818003255 |
| Provider Name | Braiden S Wilson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184336109 PECOS PAC ID: 7719358613 Enrollment ID: I20230131002495 |
| Provider Name | Jared P Brady |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518666973 PECOS PAC ID: 9436523057 Enrollment ID: I20230322002938 |
| Provider Name | Joshua G Thomas |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659158483 PECOS PAC ID: 3971959958 Enrollment ID: I20231026004175 |
| Mailing Address | Practice Location Address |
|---|---|
| Orem Sports Medicine Center, Llc 524 W 300 N Ste 201, Provo, UT 84601-2669 Ph: (801) 370-9981 | Orem Sports Medicine Center, Llc 980 E 800 N Ste 103, Orem, UT 84097-4261 Ph: (801) 226-0599 |
Mckell Therapy Group, Pc Physical Therapist Medicare: Medicare Enrolled Practice Location: 504 E 770 N, Orem, UT 84097 Phone: 801-224-2177 Fax: 801-224-2195 | |
Roger E Pack, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 412 W. 800 N., Orem, UT 84057 Phone: 801-701-6515 | |
Dr. Matthew Framptom Bushnell, D.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 252 N State St, Orem, UT 84057 Phone: 801-226-0599 Fax: 801-226-3145 | |
Tucker Gamble, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1163 E 1220 N, Orem, UT 84097 Phone: 801-633-8151 | |
Mark Stout Mcomber, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 331 N 400 W, Orem, UT 84057 Phone: 801-224-4080 | |
Kirk W Newbold, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 684 W 800 N, #110, Orem, UT 84057 Phone: 801-224-2250 Fax: 801-224-2655 | |
Mrs. Debra Ann Oborn, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 607 N 1200 W, Orem, UT 84057 Phone: 801-224-4131 Fax: 801-226-3482 |