Basic Information
| Provider Information | |||||||||
| NPI: | 1770083859 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANGTON | ||||||||
| FirstName: | BRYAN | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4896 S HIGHLAND CIR APT 14 | ||||||||
| Address2: | |||||||||
| City: | HOLLADAY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841176073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6199226544 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2390 S REDWOOD RD | ||||||||
| Address2: | |||||||||
| City: | WEST VALLEY CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841192027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8019751600 | ||||||||
| FaxNumber: | 8019751666 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2018 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 10618586-2401 | UT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.