MEDICARE: DR. MOLLY K WILLIAMS 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	5932590-2401	UT

General Provider Information

NPI Number	:	1376536987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOLLY K WILLIAMS DPT

Provider Business Mailing Address
First Line	:	7390 S CREEK RD STE 104
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-6121
Country	:	US
Telephone Number	:	801-456-9898
Fax Number	:	801-456-9899

Provider Business Practice Location Address
First Line	:	7390 S CREEK RD STE 104
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-6121
Country	:	US
Telephone Number	:	801-456-9898
Fax Number	:	801-456-9899

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	02/16/2022

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