MEDICARE: KATHRINE M DETEMPLE OTR

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	225XH1200X	Hand Occupational Therapist	1064444201	UT

General Provider Information

NPI Number	:	1174738843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRINE M DETEMPLE OTR

Provider Business Mailing Address
First Line	:	1601 WESTSILVER SPRINGS RD
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84098-5902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	590 WAKARA WAY
Second Line	:
City	:	SLC
State	:	UT
Zip	:	84108-1200
Country	:	US
Telephone Number	:	801-587-7001
Fax Number	:

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	10/20/2021

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Directions to “ KATHRINE M DETEMPLE OTR” Practice Location

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