Healthcare Provider Details

I. General information

NPI: 1780439513
Provider Name (Legal Business Name): ISABELLE RAYLIN TZENG PT,DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2024
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5770 S FASHION BLVD BLDG 5 SUITE 210
MURRAY UT
84107
US

IV. Provider business mailing address

PO BOX 30180
SALT LAKE CITY UT
84130-0180
US

V. Phone/Fax

Practice location:
  • Phone: 801-314-5220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14236904-2401
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number1389788
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: