MEDICARE: ONE TO ONE PHYSICAL THERAPY PC

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	346507-2401	UT

General Provider Information

NPI Number	:	1942531637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE TO ONE PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	8899 S 700 E
Second Line	:	SUITE 130
City	:	SANDY
State	:	UT
Zip	:	84070-1810
Country	:	US
Telephone Number	:	801-561-4121
Fax Number	:	801-561-1540

Provider Business Practice Location Address
First Line	:	8899 S 700 E
Second Line	:	SUITE 130
City	:	SANDY
State	:	UT
Zip	:	84070-1810
Country	:	US
Telephone Number	:	801-561-4121
Fax Number	:	801-561-1540

Authorized Official
Title or Position	:	OWNER/PHYSICAL THERAPIST
Name	:	MRS. AMY L TRUJILLO
Credential	:	P.T.
Telephone Number	:	801-561-4121

Provider Enumeration Date	:	01/20/2010
Last Update Date	:	01/20/2010

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Directions to “ONE TO ONE PHYSICAL THERAPY PC ” Practice Location

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