Basic Information
| Provider Information | |||||||||
| NPI: | 1679866594 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AASBY | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | ERIK | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | D.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 70689 | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841700689 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017460770 | ||||||||
| FaxNumber: | 8017460771 | ||||||||
| Practice Location | |||||||||
| Address1: | 102 W. MAIN ST., STE 103 | ||||||||
| Address2: | |||||||||
| City: | EVERSON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3609664810 | ||||||||
| FaxNumber: | 3609662884 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2011 | ||||||||
| LastUpdateDate: | 05/25/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT60182352 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.