Doctor Name: | RUSSELL JACK GATENBY |
NPI Number: | 1134241904 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 119421-2401 |
Business Practice Address: | 1184 E 80 N American Fork, UT - 840032906 |
Business Phone Number: | 8017567777 |
Business Fax Number: | |
Mailing Address: | 222 N 1020 E, AMERICAN FORK |
State: | UT |
Postal Code: | 840032957 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 119421-2401 |
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 |