MEDICARE: DR. ZACHARY ALLEN ALLRED D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	370123-1204	UT
2	390200000X	Student in an Organized Health Care Education/Training Program	58.003758	OH

General Provider Information

NPI Number	:	1538393319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZACHARY ALLEN ALLRED D.O.

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:	807-357-8818
Fax Number	:

Provider Business Practice Location Address
First Line	:	395 W COUGAR BLVD STE 802
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-3311
Country	:	US
Telephone Number	:	801-357-8818
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2009
Last Update Date	:	03/30/2026

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