Individual
TIMOTHY DAVID ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1409 W 1400 N, MAPLETON, UT 84664-3358
(801) 489-5633
Mailing address
1409 W 1400 N, MAPLETON, UT 84664-3358
(801) 489-5633
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
310372-2401
UT
2251G0304X
Geriatric Physical Therapist
310372-2401
UT
2251X0800X
Orthopedic Physical Therapist
310372-2401
UT
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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