# DELTA PHYSICAL THERAPY AND SPORTS MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fillmore Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275726788
- **Authorized official:** DR. HOWARD QUACKENBUSH D.P.T. (PRESIDENT)
- **Authorized official phone:** (435) 864-2551

## Contact information

- **Practice address:** 770 S HIGHWAY 99, SUITE A, FILLMORE, UT 84631
- **Practice address phone:** (435) 743-6100
- **Practice address fax:** (435) 743-6161
- **Mailing address:** 95 WHITE SAGE AVE STE C, DELTA, UT 84624-5555
- **Mailing address phone:** (435) 864-2551
- **Mailing address fax:** (435) 864-3573

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 08/20/2007
- **Last updated:** 12/28/2018