Provider Demographics
NPI:1699895797
Name:PHYSICAL THERAPY AT THE CROSSROADS
Entity type:Organization
Organization Name:PHYSICAL THERAPY AT THE CROSSROADS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:801-768-3105
Mailing Address - Street 1:1305 N COMMERCE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5307
Mailing Address - Country:US
Mailing Address - Phone:801-768-3105
Mailing Address - Fax:801-766-0188
Practice Address - Street 1:1305 N COMMERCE DR STE 100
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84043-5307
Practice Address - Country:US
Practice Address - Phone:801-768-3105
Practice Address - Fax:801-766-0188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty