Individual
BRET MAIERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
220 MILLPOND, SUITE 109, STANSBURY PARK, UT 84074-9745
(435) 882-4144
(435) 882-4151
Mailing address
1900 FLANDRO DR 190, POCATELLO, ID 83202-1975
(208) 233-2248
(208) 233-0219
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8715597-2401
UT
225100000X
Physical Therapist
PT60168625
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497061782
—
UT
05
—
1497061782
—
WA
01
—
P00877701
RR MEDICARE
OR
Enumeration date
08/24/2010
Last updated
12/14/2015
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