Pack, Brodie James
Pack, Brodie James is an individual health care provider with primary practice located at 11531 S District Dr Ste 1200 , South Jordan UT 84095-5782. He recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Pack, Brodie James can be contacted via phone (801) 260-3100.Contact Information
Primary practice address
11531 S District Dr Ste 1200
South Jordan UT 84095-5782
Phone: (801) 260-3100
Fax: (801) 260-3101
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 2774652-2401 | Utah |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports | 2251S0007X | 2774652-2401 | Utah |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT28869 | California |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic | 2251X0800X | 2774652-2401 | Utah |
Profile Details
| NPI number | 1871578203 |
|---|---|
| LBN Legal business name | Pack, Brodie James |
| Credentials | Master of Physical Therapy (MPT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 8th, 2005 |
| Last updated | Feb 7th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871578203 | NPPES |
| Utah | Other | 2774652-2401 | UTAH DEPARTMENT OF COMMERCE DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING |
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