Healthcare Provider Details

I. General information

NPI: 1760197776
Provider Name (Legal Business Name): HAILEE STRASRYPKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 S ORCHARD DR
BOUNTIFUL UT
84010-5017
US

IV. Provider business mailing address

2030 S MAIN ST APT 111
BOUNTIFUL UT
84010-7571
US

V. Phone/Fax

Practice location:
  • Phone: 801-696-6590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: