Provider Demographics
NPI:1073345617
Name:NEW PARADIGM PHYSICAL THERAPY
Entity type:Organization
Organization Name:NEW PARADIGM PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WALDO
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:801-641-4661
Mailing Address - Street 1:699 E SOUTH TEMPLE STE 260
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-4258
Mailing Address - Country:US
Mailing Address - Phone:801-641-4661
Mailing Address - Fax:
Practice Address - Street 1:699 E SOUTH TEMPLE STE 260
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-4258
Practice Address - Country:US
Practice Address - Phone:801-641-4661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy