Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

David Blake

Individual provider Physical Therapist · NPI 1083467179

David Blake is a Physical Therapist in Private Practice in Salt Lake City, Utah. Qualified in 2024, 2 years ago. Practices with Mountain Land Rehabilitation LLC, a 203-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024

Practice location Address checks out

2295 S Foothill Dr Ste 1
Salt Lake City, UT 84109-4006
Phone: (801) 486-7542
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1083467179
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 8, 2024
Last updated in NPPESApril 8, 2024
Certification dateApril 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Mountain Land Rehabilitation Llc — 203 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Salt Lake City