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Organization
TRUMAN & MOORE THERAPY
Active
Organization
TRUMAN & MOORE THERAPY
Active
Other names
Enterprise Valley Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WYATT D BANKS PT (PRESIDENT)
(435) 878-2722
Entity
Organization
Contact information
Practice address
660 E MAIN ST, BLDG B, ENTERPRISE, UT 84725-0549
(435) 878-2722
(435) 878-2723
Mailing address
PO BOX 549, ENTERPRISE, UT 84725-0549
(775) 726-3117
(775) 726-3118
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7043969-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00669998
RAIL ROAD MEDICARE PTAN
UT
Enumeration date
07/17/2008
Last updated
01/23/2020
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