MEDICARE: JOSHUA DAVID FUHRIMAN PT

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	3724222401	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376649400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA DAVID FUHRIMAN PT

Provider Business Mailing Address
First Line	:	PO BOX 711185
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84171
Country	:	US
Telephone Number	:	801-942-2729
Fax Number	:	801-942-5955

Provider Business Practice Location Address
First Line	:	9301 S WIGHTS FORT ROAD
Second Line	:	SUITE 215
City	:	WEST JORDAN
State	:	UT
Zip	:	84088
Country	:	US
Telephone Number	:	801-282-2200
Fax Number	:	801-282-2220

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	12/10/2021

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