Kelsie Lenna Wimmer, PTA
Individual provider Active NPI Physical Therapy Assistant · Cedar Hills, UT
NPI 1003620188 · NPPES record last updated Feb 6, 2025
Key facts
- NPI
- 1003620188
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 14202060-2402 (UT)
- Practice address
- 4587 W Cedar Hills Dr Ste 110
Cedar Hills, UT 84062-8827 - Phone
- (801) 406-6943
- NPI assigned
- Feb 6, 2025
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14202060-2402 | UT | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain Land Rehabilitation LLC | Current |
Accepting new patients |
Locations
4587 W Cedar Hills Dr
Ste 110
Cedar Hills, UT 84062
Phone (801) 406-6943
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 14202060-2402 | UT | Yes |
Addresses
Primary practice location
4587 W Cedar Hills Dr Ste 110
Cedar Hills, UT 84062-8827
Mailing address
10165 N 6960 W
Highland, UT 84003-9223
Phone (801) 425-5268
Other providers in Cedar Hills, UT
- Kara Cattani Thompson
- Dana Tischler
- Ut Specialty Dental Services, PLLC
- Walmart Inc.
- Joslyn Dana Wilson
- Craig Young
All providers in Cedar Hills, UT · Physical Therapy Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.