Provider Demographics
NPI:1316677305
Name:REACTIVE PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:REACTIVE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:435-232-5773
Mailing Address - Street 1:205 WILLOW VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:CO
Mailing Address - Zip Code:81052-3841
Mailing Address - Country:US
Mailing Address - Phone:143-523-2577
Mailing Address - Fax:
Practice Address - Street 1:550 W 465 N STE 504
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-8014
Practice Address - Country:US
Practice Address - Phone:435-232-5773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy