MEDICARE: ROCKY MOUNTAIN THERAPY SERVICES

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	225X00000X	Occupational Therapist	313389-2401	UT
2	225100000X	Physical Therapist		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	:	1306864863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKY MOUNTAIN THERAPY SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 540640
Second Line	:
City	:	NORTH SALT LAKE
State	:	UT
Zip	:	84054-0640
Country	:	US
Telephone Number	:	801-987-8700
Fax Number	:	801-987-8701

Provider Business Practice Location Address
First Line	:	3540 S 4000 W STE 340
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-3287
Country	:	US
Telephone Number	:	801-417-5017
Fax Number	:	801-417-5016

Authorized Official
Title or Position	:	COO
Name	:	TY BERRETT
Credential	:
Telephone Number	:	801-243-2406

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	06/14/2019

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Directions to “ROCKY MOUNTAIN THERAPY SERVICES ” Practice Location

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