Individual
ROBERT D. CERVANTEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2015 SIDEWINDER DR., PARK CITY, UT 84060
(435) 645-9095
(435) 645-9092
Mailing address
PO BOX 682226, PARK CITY, UT 84068
(435) 645-9095
(435) 645-9092
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
284982-2401
UT
225100000X
Physical Therapist
849822401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280669988016
—
UT
Enumeration date
01/24/2007
Last updated
12/03/2021
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