Michelle Anumba, PT

Individual provider Active NPI Physical Therapist · Salt Lake City, UT

NPI 1669971974 · NPPES record last updated Aug 15, 2023

Key facts

NPI
1669971974
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
13423904-2401 (UT)
Practice address
1420 500 W
Salt Lake City, UT 84115
Phone
(909) 262-4854
NPI assigned
Feb 2, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
3985NVMDPulmonary Disease Physician
13423904-2401UTMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Physical Therapist 225100000X 13423904-2401 UT Yes
Physical Therapist 225100000X 3985 NV

Addresses

Primary practice location

1420 500 W
Salt Lake City, UT 84115

Mailing address

5663 W Red Ridge LN
Salt Lake City, UT 84118-5004

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Physical Therapist in Utah

Sources for this page

Verify at the official NPI Registry.