NPI 1649750621 · live from the CMS NPI Registry
Nicholas Burke
Physical Therapist, Neurology in Salt Lake City, UT. National Provider Identifier 1649750621, active.
NPI record
| NPI | 1649750621 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist, Neurology 2251N0400X |
| Practice location | 50 N Medical Dr, Salt Lake City, UT 84132 |
| Practice phone | 801-587-3422 |
| Mailing address | 765 E 400 S Apt 322, Salt Lake City, UT 84102 |
| Enumerated | August 18, 2018 |
| Last updated | December 3, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapist, Neurology primary | 2251N0400X | 108617852401 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.