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NPI Code Detail

MEDICARE: ROCKY MOUNTAIN THERAPY SERVICES LLC

MEDICARE: ROCKY MOUNTAIN THERAPY SERVICES LLC
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 Therapist117406-2401UT

General Provider Information

NPI Number : 1912180993
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKY MOUNTAIN THERAPY SERVICES LLC
Provider Business Mailing Address
First Line : PO BOX 702128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84170-2128
Country : US
Telephone Number : 801-708-7867
Fax Number : 801-677-1510
Provider Business Practice Location Address
First Line : 441 S REDWOOD RD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84104-3539
Country : US
Telephone Number : 801-975-1403
Fax Number : 801-973-0391
Authorized Official
Title or Position : PRESIDENT
Name : PAUL G WORTLEY
Credential : PT
Telephone Number : 801-417-5017
Provider Enumeration Date : 12/12/2007
Last Update Date : 04/06/2010

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Directions to “ROCKY MOUNTAIN THERAPY SERVICES LLC ” Practice Location

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