MEDICARE: MRS. ROBIN ELIZABETH KOLFF 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	2774663-2401	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215002936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBIN ELIZABETH KOLFF PT

Provider Business Mailing Address
First Line	:	14071 SOUTH OLD DOBBIN LN
Second Line	:
City	:	DRAPER
State	:	UT
Zip	:	84020
Country	:	US
Telephone Number	:	801-571-0941
Fax Number	:

Provider Business Practice Location Address
First Line	:	3855 S 700 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106
Country	:	US
Telephone Number	:	801-270-2524
Fax Number	:

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	07/08/2007

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