Organization
SPORTS & ORTHOPEDIC PHYSICAL THERAPY OF KAYSVILLE LC
Active
Parent organization
MOUNTAIN LAND REHABILITATION INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOUNTAIN LAND REHABILITATION INC
Authorized official
MR. MARK ANDERSON PT (PRESIDENT)
(801) 942-3311
Entity
Organization
Contact information
Practice address
1188 SPORTSPLEX DR, STE. 101, KAYSVILLE, UT 84037-9591
(801) 547-1155
(801) 547-1173
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171-1185
(801) 942-3311
(801) 942-5955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
08/15/2006
Last updated
07/02/2008
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