# SUNDANCE CIRCLE HIPPOTHERAPY LLC

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

## Provider details

- **NPI number:** 1588257687
- **Authorized official:** JOHN W PAYNE DPT (PHYSICAL THERAPIST/OWNER)
- **Authorized official phone:** (435) 999-0912

## Contact information

- **Practice address:** 16520 92ND ST E, SUMNER, WA 98390-8155
- **Practice address phone:** (435) 999-0912
- **Mailing address:** 1392 W 6500 S, HYRUM, UT 84319-7105
- **Mailing address phone:** (435) 999-0912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 02/19/2021
- **Last updated:** 03/16/2022