MEDICARE: MCKENZIE SILBERMAN

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	225X00000X	Occupational Therapist	424576	UT

General Provider Information

NPI Number	:	1083202873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MCKENZIE SILBERMAN

Provider Business Mailing Address
First Line	:	3738 S 700 E # 1
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-1156
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3738 S 700 E # 1
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-1156
Country	:	US
Telephone Number	:	801-682-6548
Fax Number	:

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

Provider Enumeration Date	:	01/06/2021
Last Update Date	:	01/06/2021

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Directions to “ MCKENZIE SILBERMAN ” Practice Location

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