# BEAR RIVER HEALTHCARE LLC

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

## Provider details

- **NPI number:** 1386374189
- **Authorized official:** LEE JOHNSON (TREASURER)
- **Authorized official phone:** (208) 401-1369

## Contact information

- **Practice address:** 1153 N MAIN ST STE B100, LOGAN, UT 84341-2573
- **Practice address phone:** (435) 752-2291
- **Practice address fax:** (435) 213-2230
- **Mailing address:** 1153 N MAIN ST STE B100, LOGAN, UT 84341-2573
- **Mailing address phone:** (435) 752-2291
- **Mailing address fax:** (435) 213-2230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 06/14/2022
- **Last updated:** 06/14/2022