Organization
THERAPY WEST REHAB AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK CORNELL OVERLY MSPT (MANAGER)
(435) 528-7575
Entity
Organization
Contact information
Practice address
13 EAST CENTER, GUNNISON, UT 84634
(435) 528-7575
(435) 528-7000
Mailing address
PO BOX 396, GUNNISON, UT 84634-0396
(435) 528-7575
(435) 528-7000
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
14354213
UT
Other
Enumeration date
12/21/2016
Last updated
12/21/2016
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