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Organization
MOUNTAIN LAND OUTPATIENT SERVICES
Active
Organization
MOUNTAIN LAND OUTPATIENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK A. ANDERSON PT (PRESIDENT OWNER)
(801) 942-3311
Entity
Organization
Contact information
Practice address
1952 E 7000 S, SUITE 100, SALT LAKE CITY, UT 84121-6877
(801) 942-3311
(801) 942-5955
Mailing address
1952 E 7000 S, SUITE 100, SALT LAKE CITY, UT 84121-6877
(801) 942-3311
(801) 942-5955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
12/14/2006
Last updated
11/16/2010
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