Organization
AVISTA PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN DAX GERBER DPT (PHYSICAL THERAPIST/OWNER)
(509) 818-9989
Entity
Organization
Contact information
Practice address
3460 S REDWOOD RD STE 3, WEST VALLEY CITY, UT 84119-3400
(509) 818-9989
Mailing address
521 N 1030 E, PLEASANT GROVE, UT 84062-4534
(509) 818-9989
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
04/24/2021
Last updated
05/28/2021
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