MEDICARE: DR. TONUA HAMILTON PT 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	174400000X	Specialist	118777-2401	UT

General Provider Information

NPI Number	:	1992820047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TONUA HAMILTON PT DPT

Provider Business Mailing Address
First Line	:	1803 HOLLYWOOD AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-3103
Country	:	US
Telephone Number	:	801-635-9447
Fax Number	:	801-272-5009

Provider Business Practice Location Address
First Line	:	4578 HIGHLAND DR
Second Line	:	SUITE 190
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4243
Country	:	US
Telephone Number	:	801-272-5008
Fax Number	:	801-272-5009

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/09/2007

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