# PREVAIL STROKE AND NEURO REHAB, LLC

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

## Provider details

- **NPI number:** 1295502029
- **Authorized official:** JONATHAN HERBERT KINZINGER DPT (PHYSICAL THERAPIST)
- **Authorized official phone:** (801) 860-3237

## Contact information

- **Practice address:** 1910 E 3060 S, SALT LAKE CITY, UT 84106-3932
- **Practice address phone:** (801) 860-3237
- **Mailing address:** 1910 E 3060 S, SALT LAKE CITY, UT 84106-3932
- **Mailing address phone:** (801) 860-3237

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 2251C2600X | Cardiopulmonary Physical Therapist | — | NULL | — |
| 2251C2600X | Cardiopulmonary Physical Therapist | — | — | — |
| 2251N0400X | Neurology Physical Therapist | — | NULL | — |
| 2251N0400X | Neurology Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 12/12/2023
- **Last updated:** 12/12/2023