# PERFORMANCE WEST PHYSICAL THERAPY

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

## Provider details

- **NPI number:** 1720148240
- **Authorized official:** AMY BUSBY (OFFICE MANAGER)
- **Authorized official phone:** (801) 295-3553

## Contact information

- **Practice address:** 1551 RENAISSANCE TOWNE DR, STE 350, BOUNTIFUL, UT 84010-7667
- **Practice address phone:** (801) 295-3553
- **Practice address fax:** (801) 295-3599
- **Mailing address:** 1551 RENAISSANCE TOWNE DR, STE 350, BOUNTIFUL, UT 84010-7667
- **Mailing address phone:** (801) 295-3553
- **Mailing address fax:** (801) 295-3599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 200631198 | UT | Yes |

## Other

- **Enumeration date:** 12/12/2006
- **Last updated:** 11/16/2012