Healthcare Provider Details

I. General information

NPI: 1962447722
Provider Name (Legal Business Name): NATALIE YEARSLEY ATC, LRPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

452 S MEDICAL DR SUITE 220
BOUNTIFUL UT
84010
US

IV. Provider business mailing address

652 W 800 N UNIT 30
CLINTON UT
84015-9441
US

V. Phone/Fax

Practice location:
  • Phone: 801-990-6286
  • Fax:
Mailing address:
  • Phone: 801-721-8376
  • Fax: 801-990-6290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: