# GATEWAY PHYSICAL THERAPY AND SPORTS REHAB

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

## Provider details

- **NPI number:** 1275098998
- **Authorized official:** DARIN CHASE (PHYSICAL THERAPIST)
- **Authorized official phone:** (435) 799-3111

## Contact information

- **Practice address:** 169 N GATEWAY DR STE 160, PROVIDENCE, UT 84332-9707
- **Practice address phone:** (435) 799-3111
- **Mailing address:** 169 N GATEWAY DR STE 160, PROVIDENCE, UT 84332-9882
- **Mailing address phone:** (435) 799-3111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/06/2019
- **Last updated:** 06/09/2022