# FAST TRACK PHYSICAL THERAPY AND SPORTS MEDICINE, PLLC

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

## Provider details

- **NPI number:** 1124263728
- **Authorized official:** DR. GEORGE A SHIRLEY PT, DPT, MS, ATC (PHYSICAL THERAPIST/OWNER)
- **Authorized official phone:** (801) 649-4690

## Contact information

- **Practice address:** 6717 SOUTH 900 EAST, SUITE 201, MIDVALE, UT 84047
- **Practice address phone:** (801) 649-4690
- **Practice address fax:** (801) 984-4011
- **Mailing address:** 6717 SOUTH 900 EAST, SUITE 201, MIDVALE, UT 84047
- **Mailing address phone:** (801) 649-4690
- **Mailing address fax:** (801) 984-4011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 6006997-2401 | UT | Yes |

## Other

- **Enumeration date:** 12/10/2008
- **Last updated:** 07/31/2009