# ALTA SPORTS THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104061084
- **Authorized official:** MR. JOHN W FEIG RPT (PRESIDENT)
- **Authorized official phone:** (801) 944-1219

## Contact information

- **Practice address:** GOLDMINER'S DAUGHTER LODGE, SUITE 1, ALTA, UT 84092-8072
- **Practice address phone:** (801) 944-1209
- **Mailing address:** PO BOX 71403, SALT LAKE CITY, UT 84171-0403
- **Mailing address phone:** (801) 944-1209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 121600-2401 | UT | Yes |

## Other

- **Enumeration date:** 12/08/2008
- **Last updated:** 12/08/2008