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NPI Code Detail

MEDICARE: ALLYSON GILMORE OTR/L

MEDICARE: ALLYSON GILMORE OTR/L
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
1225X00000XOccupational Therapist7698660-4201UT

General Provider Information

NPI Number : 1518271444
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLYSON GILMORE OTR/L
Provider Business Mailing Address
First Line : 911 BLAINE AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-3322
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10376 S JORDAN GTWY
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-3954
Country : US
Telephone Number : 801-619-3670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2010
Last Update Date : 08/03/2010

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Directions to “ ALLYSON GILMORE OTR/L” Practice Location

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