Provider Demographics
NPI:1659367845
Name:SUMSION, WILLIAM G (PT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:G
Last Name:SUMSION
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 E 400 S
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-1958
Mailing Address - Country:US
Mailing Address - Phone:801-489-5669
Mailing Address - Fax:801-489-5783
Practice Address - Street 1:684 W 800 N
Practice Address - Street 2:#110
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3658
Practice Address - Country:US
Practice Address - Phone:801-224-2250
Practice Address - Fax:801-224-2655
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT120473-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT870518224SU2OtherEMIA
UT27766OtherPEHP
UT3371410003OtherCIGNA
UT4549223OtherAETNA
UT107009324104OtherSELECT HEALTH (IHC)
UT216067OtherDMBA