MEDICARE: JOSHUA MINORI DO PLLC

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

General Provider Information

NPI Number	:	1952874703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSHUA MINORI DO PLLC

Provider Business Mailing Address
First Line	:	2232 E VIMONT AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-1741
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2232 E VIMONT AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-1741
Country	:	US
Telephone Number	:	814-931-1741
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. JOSHUA MINORI
Credential	:	DO
Telephone Number	:	814-931-1741

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	01/04/2019

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