MEDICARE: MILA RANOVIC PT

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	117165-2401	UT

General Provider Information

NPI Number	:	1205037348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILA RANOVIC PT

Provider Business Mailing Address
First Line	:	4951 S 925 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-5704
Country	:	US
Telephone Number	:	801-815-3482
Fax Number	:

Provider Business Practice Location Address
First Line	:	4951 S 925 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-5704
Country	:	US
Telephone Number	:	801-815-3482
Fax Number	:

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

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	05/07/2022

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Directions to “ MILA RANOVIC PT” Practice Location

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