Provider Demographics
NPI:1861597957
Name:ZUNDEL, MONTE ROD (MS, PT)
Entity type:Individual
Prefix:MR
First Name:MONTE
Middle Name:ROD
Last Name:ZUNDEL
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 W 1575 N
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84404-8535
Mailing Address - Country:US
Mailing Address - Phone:801-782-3500
Mailing Address - Fax:801-786-1926
Practice Address - Street 1:1638 N WASHINGTON BLVD STE 103
Practice Address - Street 2:
Practice Address - City:NORTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-3790
Practice Address - Country:US
Practice Address - Phone:801-782-3500
Practice Address - Fax:801-786-1926
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT367930-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist