Provider Demographics
NPI:1275705162
Name:WILLIAMS, SETH TALBOT (DPT)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:TALBOT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 N 370 E
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-8900
Mailing Address - Country:US
Mailing Address - Phone:801-358-2800
Mailing Address - Fax:
Practice Address - Street 1:911 N 800 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-8401
Practice Address - Country:US
Practice Address - Phone:801-426-4905
Practice Address - Fax:801-426-4953
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5989174-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist