Organization
PROACTIVE PHYSICAL TRERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID JACOBSON (COO)
(503) 510-2536
Entity
Organization
Contact information
Practice address
6095 S FASHION BLVD STE 120, MURRAY, UT 84107-7383
(801) 210-0127
Mailing address
6095 S FASHION BLVD STE 120, MURRAY, UT 84107-7383
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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