| Royce Porter, | |
|
250 W 300 N, Roosevelt, UT 84066-2336 | |
| (435) 725-7448 | |
| Not Available |
| Full Name | Royce Porter |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 250 W 300 N, Roosevelt, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093106759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 9140432-4201 (Utah) | Primary |
| Provider Name | Uintah Basin Medical Center Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1871556217 PECOS PAC ID: 0244131944 Enrollment ID: O20040226000948 |
| Mailing Address | Practice Location Address |
|---|---|
| Royce Porter, 749 S Harrison Dr, Apt C3, Roosevelt, UT 84066-3425 Ph: () - | Royce Porter, 250 W 300 N, Roosevelt, UT 84066-2336 Ph: (435) 725-7448 |
Greg Neilsen, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 250 W 300 N, Roosevelt, UT 84066 Phone: 435-722-6186 | |
Ryan James Avery, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 250 W 300 N, Roosevelt, UT 84066 Phone: 435-722-4691 | |
Amanda Garner, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 136 South 500 East, Roosevelt, UT 84066 Phone: 435-709-6553 Fax: 435-236-2282 | |
Mr. Samuel Smith, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1010 E 200 N, Roosevelt, UT 84066 Phone: 435-823-1769 |