Individual
KEVIN R MUNCEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, ATC, SCS
Contact information
Practice address
564 W 700 S STE 203, PLEASANT GROVE, UT 84062-3785
(208) 691-7738
Mailing address
443 E 340 N, VINEYARD, UT 84059-7504
(208) 691-7738
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9876846-2401
UT
225100000X
Physical Therapist
9876846-8016
UT
2255A2300X
Athletic Trainer
9876846-4810
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500764000
—
OR
Enumeration date
07/19/2017
Last updated
07/27/2025
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