Individual
MICHAEL GAGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
590 E 100 N, SUITE 1, PRICE, UT 84501-2640
(435) 613-1500
(435) 613-1501
Mailing address
PO BOX 933, PRICE, UT 84501-0933
(435) 613-1500
(435) 613-1501
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
292947-2401
UT
Other
Enumeration date
07/21/2006
Last updated
05/11/2015
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