# WASATCH PHYSICAL AND REHABILITATION MEDICINE, P.C.

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

## Provider details

- **NPI number:** 1124298377
- **Authorized official:** BRADLEY R MELVILLE M.D. (OWNER)
- **Authorized official phone:** (801) 732-5900

## Contact information

- **Practice address:** 4403 HARRISON BLVD STE 1875, OGDEN, UT 84403-3325
- **Practice address phone:** (801) 732-5900
- **Practice address fax:** (801) 732-5989
- **Mailing address:** 4403 HARRISON BLVD STE 1875, OGDEN, UT 84403-3325
- **Mailing address phone:** (801) 732-5900
- **Mailing address fax:** (801) 732-7989

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/04/2008
- **Last updated:** 06/24/2016