MEDICARE: CARSON M POCH DPT

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	14193726-2401	UT

General Provider Information

NPI Number	:	1225839624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARSON M POCH DPT

Provider Business Mailing Address
First Line	:	2628 E CRUISE BAY CT
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3259
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5151 S 900 E STE 100
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84117-6658
Country	:	US
Telephone Number	:	801-261-3321
Fax Number	:

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

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	11/30/2025

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Directions to “ CARSON M POCH DPT” Practice Location

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