Doctor Name: | MR. LELAND E DIBBLE |
NPI Number: | 1114036985 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 93-264888-2401 |
Business Practice Address: | 50 N Medical Dr Salt Lake City, UT - 841320001 |
Business Phone Number: | 8015812121 |
Business Fax Number: | |
Mailing Address: | 127 S 500 E, Suite 660 SALT LAKE CITY |
State: | UT |
Postal Code: | 841021959 |
Phone Number: | 8015876470 |
Fax Number: | 8015855629 |
NPI Enumeration Date: | 08/29/2006 |
NPI Last Update Date: | 08/20/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 93-264888-2401 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
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 |