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Organization
PROFESSIONAL THERAPY AND REHABILITATION LLC
Active
Organization
PROFESSIONAL THERAPY AND REHABILITATION LLC
Active
Other names
Peak Physical Therapy and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD H BUDGE P.T. (OWNER/PHYSICAL THERAPIST)
(801) 798-1626
Entity
Organization
Contact information
Practice address
77 S 400 W, SPANISH FORK, UT 84660-2053
(801) 798-1626
(801) 798-1236
Mailing address
77 S 400 W, SPANISH FORK, UT 84660-2053
(801) 798-1626
(801) 798-1236
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
695780
DMBA
UT
01
—
PRA03496
MOLINA HEALTHCARE
UT
01
—
QM0000076331
ALTIUS HEALTH PLANS
UT
Enumeration date
11/26/2007
Last updated
08/02/2017
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