| Doctor Name: | ROBERT D. CERVANTEZ |
| NPI Number: | 1205981628 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 849822401 |
| Business Practice Address: | 2015 Sidewinder Dr. Park City, UT - 84060 |
| Business Phone Number: | 4356459095 |
| Business Fax Number: | 4356459092 |
| Mailing Address: | Po Box 682226, PARK CITY |
| State: | UT |
| Postal Code: | 84068 |
| Phone Number: | 4356459095 |
| Fax Number: | 4356459092 |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 12/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 849822401 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| 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 |