Most Relevant Information
Provider Data
| NPI Number: | 1003302548 |
| Provider Name: | KIM MARIE MCKINNON NP |
| Entity Type: | Individual |
| Taxonomy Code: | 208100000X |
| Specialty: | Physical Medicine & Rehabilitation |
| License Number: | 294366-4405 |
Most Important Dates
| Enumeration Date: | 07/09/2018 |
| Last Updated: | 01/13/2021 |
Provider Practice Location
45 W SEGO LILY DR STE 312
SANDY
UT
840703643
Practice Location Phone/Fax
| Phone: | 8016769452 |
| Fax: | 8012069734 |
Provider Mailing Location
8197 S 5140 W
WEST JORDAN
UT
840812705
Provider Mailing Phone/Fax
| Phone: | 8018956171 |
| Fax: |