| Doctor Name: | MARK A ANDERSON |
| NPI Number: | 1003916057 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 1115262401 |
| Business Practice Address: | 885 East 9400 South Sandy, UT - 840943670 |
| Business Phone Number: | 8015620066 |
| Business Fax Number: | 8015622124 |
| Mailing Address: | Po Box 711185, SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841711185 |
| Phone Number: | 8019423311 |
| Fax Number: | 8019425955 |
| NPI Enumeration Date: | 09/22/2006 |
| NPI Last Update Date: | 06/18/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1115262401 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |