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NPI Code Detail

MEDICARE: MARIN WILLIAMS DPT

MEDICARE: MARIN 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
1225100000XPhysical Therapist13407154-2401UT

General Provider Information

NPI Number : 1740974740
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIN WILLIAMS DPT
Provider Business Mailing Address
First Line : 9844 S 1300 E STE 300
Second Line :
City : SANDY
State : UT
Zip : 84094-4693
Country : US
Telephone Number : 801-571-0099
Fax Number : 801-572-4866
Provider Business Practice Location Address
First Line : 9844 S 1300 E STE 200
Second Line :
City : SANDY
State : UT
Zip : 84094-4689
Country : US
Telephone Number : 801-572-0690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2023
Last Update Date : 06/05/2023

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