Individual
JAMES N ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1055 N 500 W, SUITE 122, PROVO, UT 84604-3305
(801) 429-0610
(801) 429-0629
Mailing address
1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1141182401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
219420
ALTIUS
UT
01
—
64-00632
UNITED HEALTHCARE
UT
01
—
660612
DMBA
UT
01
—
74399
PEHP
UT
01
—
870281028JA2
EMIA
UT
01
—
P00132853
PALMETTO
UT
Enumeration date
09/02/2006
Last updated
11/27/2023
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