MEDICARE: ANSLEY TRAMELL

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	8306226-2401	UT

General Provider Information

NPI Number	:	1215287024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANSLEY TRAMELL

Provider Business Mailing Address
First Line	:	2759 E 1600 S
Second Line	:
City	:	SPANISH FORK
State	:	UT
Zip	:	84660-2692
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 E 1300 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-1949
Country	:	US
Telephone Number	:	509-263-6530
Fax Number	:

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

Provider Enumeration Date	:	09/19/2012
Last Update Date	:	09/19/2012

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Directions to “ ANSLEY TRAMELL ” Practice Location

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