MEDICARE: MEGAN MIYAWAKI 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	13153495-8016	UT

General Provider Information

NPI Number	:	1588376594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MIYAWAKI DPT

Provider Business Mailing Address
First Line	:	345 N 2550 W
Second Line	:
City	:	WEST POINT
State	:	UT
Zip	:	84015-4813
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3024 W 300 N STE B
Second Line	:
City	:	WEST POINT
State	:	UT
Zip	:	84015-7259
Country	:	US
Telephone Number	:	801-825-7500
Fax Number	:

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

Provider Enumeration Date	:	12/21/2022
Last Update Date	:	12/21/2022

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