MEDICARE: JOHN SUGIYAMA

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	2251N0400X	Neurology Physical Therapist	11452481-2401	UT

General Provider Information

NPI Number	:	1457206849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN SUGIYAMA

Provider Business Mailing Address
First Line	:	280 RIVER PARK DR STE 110
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-5765
Country	:	US
Telephone Number	:	385-446-4161
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 RIVER PARK DR STE 110
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-5765
Country	:	US
Telephone Number	:	385-446-4161
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ JOHN SUGIYAMA ” Practice Location

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