Organization
TOTAL REHAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONT B DIDERICKSEN MPT (CEO)
(435) 734-7178
Entity
Organization
Contact information
Practice address
250 AMERICAN WAY, BRIGHAM CITY, UT 84302-2074
(435) 734-7178
Mailing address
551 S 455 E, SMITHFIELD, UT 84335-1355
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
UT
Other
Enumeration date
12/05/2007
Last updated
12/05/2007
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