Mont Didericksen, PT Valid NPI

Individual provider · Physical Therapist · Smithfield, UT

NPI

1063963825

Type

Individual (Type 1)

Primary specialty

Physical Therapist

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225100000X

Sex

Male

Sole proprietor

No

Enumerated

2016-10-17

Last updated

2016-10-17