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General NPI Number Information
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NPI Number | 1164914149
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Entity Type | Individual
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Provider Name | JAMES MICHAEL WILKS PT
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Gender | Male
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 5848 S 300 E
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City | MURRAY
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State | UT
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Zip | 84107-6157
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Country | US
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Telephone | 801-314-4040
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 25537
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City | SALT LAKE CITY
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State | UT
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Zip | 84125-0537
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10835136-2401
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License Number State | UT
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