MEDICARE: DANIEL SCOTT GILLESPIE

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	278000-2401	UT

General Provider Information

NPI Number	:	1568473577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL SCOTT GILLESPIE

Provider Business Mailing Address
First Line	:	PO BOX 25537
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84125-0537
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1333 N MAIN ST STE 6
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-9314
Country	:	US
Telephone Number	:	435-868-6200
Fax Number	:	435-868-6201

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	04/04/2024

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Directions to “ DANIEL SCOTT GILLESPIE ” Practice Location

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