Healthcare Provider Details

I. General information

NPI: 1376447227
Provider Name (Legal Business Name): KRISTEN JUDITH MALEBRANCHE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S 400 E
BOUNTIFUL UT
84010-4933
US

IV. Provider business mailing address

1357 E BAER CANYON RD
FRUIT HEIGHTS UT
84037-2377
US

V. Phone/Fax

Practice location:
  • Phone: 801-295-2361
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: