Custom Specialty Rehab

NPI #1720363898 in Hooper, Utah

Provider Information

NPI Number: 1720363898
Entity Type: Organization
Organization Name: Custom Specialty Rehab
Primary Specialty: Physical Therapist
Enumeration Date: Oct 20, 2011
Last Updated: Oct 20, 2011

Practice Location

Address: 5820 W 3800 S
City: Hooper
State: Utah
ZIP Code: 84315-9803
Phone: (801) 781-0084

Authorized Official

Name: SCOTT CHRISTIAN PAULSEN
Title: OWNER
Phone: (801) 781-0084

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Physical Therapist	225100000X	Primary

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