MEDICARE: MS. CHELSEY M KING 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	8217316-2401	UT

General Provider Information

NPI Number	:	1073875803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHELSEY M KING DPT

Provider Business Mailing Address
First Line	:	3497 W 3500 S
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-2537
Country	:	US
Telephone Number	:	208-403-4375
Fax Number	:	801-987-8701

Provider Business Practice Location Address
First Line	:	3497 W 3500 S
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-2537
Country	:	US
Telephone Number	:	208-403-4375
Fax Number	:	801-987-8701

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

Provider Enumeration Date	:	06/07/2012
Last Update Date	:	06/07/2012

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