Provider Demographics
NPI:1174115992
Name:ENGAGE PHYSICAL THERAPY & WELLNESS
Entity type:Organization
Organization Name:ENGAGE PHYSICAL THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:801-413-3857
Mailing Address - Street 1:515 S 700 E STE 2D
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2858
Mailing Address - Country:US
Mailing Address - Phone:801-413-3857
Mailing Address - Fax:
Practice Address - Street 1:515 S 700 E STE 2D
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2858
Practice Address - Country:US
Practice Address - Phone:801-413-3857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty