MEDICARE: ELISE AMELIA BEGG PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	14219846-2401	UT

General Provider Information

NPI Number	:	1164370433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISE AMELIA BEGG PT, DPT

Provider Business Mailing Address
First Line	:	455 W 200 N UNIT 228
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-1167
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	597 PARKWAY DR STE C
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84098-5733
Country	:	US
Telephone Number	:	435-649-7335
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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