Individual
MR. KELLY D WARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
331 N 400 W, OREM, UT 84057-1913
(801) 224-4080
(801) 226-7831
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(801) 357-7475
(801) 357-7997
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2907312401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2907312401
UTAH STATE LICENSE
UT
Enumeration date
08/05/2006
Last updated
07/08/2007
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