Healthcare Provider Details

I. General information

NPI: 1831046606
Provider Name (Legal Business Name): ALEX C GRIES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3784 W VALLEY VIEW DR
CEDAR HILLS UT
84062-8085
US

IV. Provider business mailing address

15 W CASCADE AVE
ALPINE UT
84004-2505
US

V. Phone/Fax

Practice location:
  • Phone: 801-407-9998
  • Fax:
Mailing address:
  • Phone: 801-494-4722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberF25-128114
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: