Provider Demographics
NPI:1740064930
Name:CHYNOWETH, WILLIAM ETHAN (DPT, PT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ETHAN
Last Name:CHYNOWETH
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4265 S 500 E UNIT A
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2871
Mailing Address - Country:US
Mailing Address - Phone:505-331-9876
Mailing Address - Fax:
Practice Address - Street 1:6272 S HIGHLAND DR # 203
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84121-2126
Practice Address - Country:US
Practice Address - Phone:180-187-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT6146225100000X
SC12449225100000X
UT14236413-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist