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PACK PHYSICAL THERAPY INC. NPI 1336413798


NPI Information

NPI: 1336413798
Provider Name: PACK PHYSICAL THERAPY, INC.

Doing Business As: IMPACKT PHYSICAL THERAPY AND SPORTS RECOVERY

Classification: Physical Therapist - 2251X0800X
Entity Type: Organization

Specialization: Orthopedic

Address:
11531 S DISTRICT DR STE 1200
SOUTH JORDAN, UT
ZIP 84095
Phone: (949) 350-6370
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PACK PHYSICAL THERAPY, INC. is an orthopedic physical therapist in South Jordan, UT. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice. PACK PHYSICAL THERAPY, INC. NPI is 1336413798. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Impackt Physical Therapy And Sports Recovery.

The provider's business location address is:

11531 S DISTRICT DR STE 1200
SOUTH JORDAN, UT
ZIP 84095-782
Phone: (949) 350-6370

The provider's authorized official is Brodie James Pack .
The authorized official title is President/physical Therapist and has the following contact phone number (801) 260-3100.

The enumeration date for this NPI number is 3/2/2012 and was last updated on 2/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1225100000XPhysical Therapist28869CALIFORNIANo
2225100000XPhysical TherapistNo
32251H1200XPhysical TherapistHand28869CALIFORNIANo
42251S0007XPhysical TherapistSports28869CALIFORNIANo
52251S0007XPhysical TherapistSportsNo
62251X0800XPhysical TherapistOrthopedicNo
7261QP2000XClinic/CenterPhysical TherapyNo
82251X0800XPhysical TherapistOrthopedic28869CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12774652-2401OTHERUTAHUTAH DEPARTMENT OF COMMERCE DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.