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NPI Code Detail

MEDICARE: DR. ANDREW CHASE TOLLEFSON DPT, CSCS

MEDICARE: DR. ANDREW CHASE TOLLEFSON DPT, CSCS
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
1225100000XPhysical Therapist14287890-2401UT

General Provider Information

NPI Number : 1275466864
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW CHASE TOLLEFSON DPT, CSCS
Provider Business Mailing Address
First Line : 1590 E SPRING RUN DR
Second Line :
City : HOLLADAY
State : UT
Zip : 84117-6855
Country : US
Telephone Number : 320-444-5511
Fax Number :
Provider Business Practice Location Address
First Line : 500 FOOTHILL DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84148-0001
Country : US
Telephone Number : 801-582-1565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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