Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 366802-2401 | UT |
NPI | 1417432766 |
---|---|
Provider Name | Dr. Robin Leroy Cecil |
First Address | Sandy, UT 84093-2209 |
Second Address | Sandy, UT 84093-2209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2018 |
Last Update Date | 02/10/2018 |