Provider Demographics
NPI:1730254319
Name:ZIONS REHABILITATION, INC
Entity type:Organization
Organization Name:ZIONS REHABILITATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BRAMALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-652-4205
Mailing Address - Street 1:1490 E FOREMASTER DR BLDG B
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4510
Mailing Address - Country:US
Mailing Address - Phone:435-652-4205
Mailing Address - Fax:435-688-2078
Practice Address - Street 1:1490 E FOREMASTER DR BLDG B
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4510
Practice Address - Country:US
Practice Address - Phone:435-652-4205
Practice Address - Fax:435-688-2078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT208100000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========000Medicaid
UT=========000Medicaid