# LIVEWELL PHYSICAL THERAPY

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

## Provider details

- **NPI number:** 1619119732
- **Authorized official:** JANET MYSHRALL P.T. (OWNER)
- **Authorized official phone:** (435) 901-3579

## Contact information

- **Practice address:** 5976 FAIRVIEW DR, PARK CITY, UT 84098-6160
- **Practice address phone:** (435) 901-3579
- **Practice address fax:** (435) 608-6566
- **Mailing address:** 5976 FAIRVIEW DR, PARK CITY, UT 84098-6160
- **Mailing address phone:** (435) 901-3579
- **Mailing address fax:** (435) 658-9934

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 290437-2401 | UT | Yes |

## Other

- **Enumeration date:** 04/03/2009
- **Last updated:** 05/11/2018