IndividualActive
Mont Didericksen, PT
NPI 1063963825 · Physical Therapist · Smithfield, UT
Provider details
- NPI number
- 1063963825
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
551 S 455 E
Smithfield, UT 84335-1355
Phone: (435) 757-4847
Approximate (ZIP-level) locationGet directions
Mailing address
551 S 455 E
Smithfield, UT 84335-1355
Registry dates
- Enumerated
- 2016-10-17
- Last updated
- 2016-10-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.