Healthcare Provider Details

I. General information

NPI: 1700278033
Provider Name (Legal Business Name): CHRISTIAN DAVID HUNT ATC, LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9338 N AVANYU CT
CEDAR HILLS UT
84062-8792
US

IV. Provider business mailing address

9338 N AVANYU CT
CEDAR HILLS UT
84062-8792
US

V. Phone/Fax

Practice location:
  • Phone: 801-368-1846
  • Fax:
Mailing address:
  • Phone: 801-368-1846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number80735864810
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number80735864701
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: