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Specialty details in registry · South Salt Lake, UT

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At a glance

3746 S 300 E, South Salt Lake, UT 84115-4822

NPPES record updated Sep 16, 2025. Public records can lag behind changes at a practice.

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  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
  • Do you provide the service I need at this address?
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Insurance participation and appointment availability are not established by these public records.

Practice location

3746 S 300 E
South Salt Lake, UT 84115-4822
Professional details: NPI, taxonomy & registry record
NPI1306650726
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
320900000X
Enumeration date
Feb 5, 2025
Record updated
Sep 16, 2025
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

251C00000X

Specialty details in registry

253Z00000X

Specialty details in registry

320900000X · Primary

Specialty details in registry

373H00000X

Specialty details in registry

385HR2060X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

3746 S 300 E
South Salt Lake, UT 84115-4822
Phone
(801) 800-1522
Mailing address
1422 E VINEYARD CT

SALT LAKE CITY, UT 841064406
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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