Provider Demographics
NPI:1871976183
Name:PAGNANI PHYSICAL THERAPY
Entity type:Organization
Organization Name:PAGNANI PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGNANI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:435-833-9070
Mailing Address - Street 1:2321 N 400 E STE 400
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-3440
Mailing Address - Country:US
Mailing Address - Phone:435-833-9070
Mailing Address - Fax:
Practice Address - Street 1:2321 N 400 E STE 400
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-3440
Practice Address - Country:US
Practice Address - Phone:435-833-9070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty