| Organization Name: | ALTA THERAPIES LC |
| NPI Number: | 1962522078 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DUSTIN CRAGUN (GENERAL MANAGER) |
| Mailing Address: | 350 E 300 S Ste 120 Bountiful |
| State: | UT US |
| Postal Code: | 840104914 |
| Phone Number: | 8016932303 |
| Fax Number: | 8663795965 |
| NPI Enumeration Date: | 03/30/2007 |
| NPI Last Update Date: | 05/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 3578 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| 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 |