MEDICARE: DAVIS TIMPSON 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	208100000X	Physical Medicine & Rehabilitation Physician	10835126-2401	UT
2	225100000X	Physical Therapist	10835126-2401	UT

General Provider Information

NPI Number	:	1831681923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVIS TIMPSON 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	:	801-572-0690
Fax Number	:

Provider Business Practice Location Address
First Line	:	6360 S 3000 E # 150
Second Line	:
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84121-6923
Country	:	US
Telephone Number	:	385-900-5094
Fax Number	:

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

Provider Enumeration Date	:	06/04/2018
Last Update Date	:	01/08/2023

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Directions to “ DAVIS TIMPSON DPT” Practice Location

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