| Mr Kevin Dee Church, PT | |
|
5255 S 4015 W, Suite 205, Taylorsville, UT 84118-4257 | |
| (801) 957-1797 | |
| (801) 957-1941 |
| Full Name | Mr Kevin Dee Church |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 5255 S 4015 W, Taylorsville, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376678334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 119835-2401 (Utah) | Primary |
| 225100000X | Physical Therapist | 5665 (Arizona) | Secondary |
| Provider Name | Kevin Church Physical Therapy Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1194022418 PECOS PAC ID: 8729269741 Enrollment ID: O20110224000295 |
| Provider Name | Excel Rehab Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1477877744 PECOS PAC ID: 5597945741 Enrollment ID: O20110623000617 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Kevin Dee Church, PT 5255 S 4015 W, Suite 205, Taylorsville, UT 84118-4257 Ph: (801) 957-1797 | Mr Kevin Dee Church, PT 5255 S 4015 W, Suite 205, Taylorsville, UT 84118-4257 Ph: (801) 957-1797 |
Worksite Wellness Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2520 W 4700 S, Taylorsville, UT 84118 Phone: 801-599-6412 Fax: 801-964-2435 | |
Carson Chandler, Physical Therapist Medicare: Medicare Enrolled Practice Location: 3845 W 4700 S, Taylorsville, UT 84129 Phone: 801-840-2191 | |
Brook Dummer, DPT, CEAS Physical Therapist Medicare: Medicare Enrolled Practice Location: 3845 W 4700 S, Taylorsville, UT 84129 Phone: 801-840-2000 | |
Jeanette Bierman, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4179 S Riverboat Rd Ste 110, Taylorsville, UT 84123 Phone: 801-337-4475 | |
Mr. Robby S Luck, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 5547 S 4015 W, #7, Taylorsville, UT 84118 Phone: 801-967-6055 Fax: 801-967-6934 | |
Elizabeth Casas Torres, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2195 W 5400 S Ste 105, Taylorsville, UT 84129 Phone: 385-255-8255 | |
Mr. Rodney A Miyasaki, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5547 S 4015 W, #7, Taylorsville, UT 84129 Phone: 801-967-6055 Fax: 801-967-6934 |