MEDICARE: ADRIAN PARKER CALL MPT, 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	5294497-2401	UT
2	225100000X	Physical Therapist	PT3598	MS
3	225100000X	Physical Therapist	PT00009590	WA
4	225100000X	Physical Therapist	PT2050	ID

General Provider Information

NPI Number	:	1932328838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIAN PARKER CALL MPT, DPT

Provider Business Mailing Address
First Line	:	4607 MIDLAND DR # 201
Second Line	:
City	:	WEST HAVEN
State	:	UT
Zip	:	84401-9507
Country	:	US
Telephone Number	:	801-732-8700
Fax Number	:

Provider Business Practice Location Address
First Line	:	4607 MIDLAND DR # 201
Second Line	:
City	:	WEST HAVEN
State	:	UT
Zip	:	84401-9507
Country	:	US
Telephone Number	:	801-732-8700
Fax Number	:

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

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	07/08/2007

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