Provider Demographics
NPI:1437207016
Name:NUMBERS, CHARLES B (MS, PT, DPT)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:B
Last Name:NUMBERS
Suffix:
Gender:M
Credentials:MS, PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12225 S NICKLAUS RD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-5938
Mailing Address - Country:US
Mailing Address - Phone:801-209-4856
Mailing Address - Fax:
Practice Address - Street 1:12226 S 1000 E
Practice Address - Street 2:SUITE 1
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-3205
Practice Address - Country:US
Practice Address - Phone:801-523-3415
Practice Address - Fax:801-523-1843
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT49175112401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist