Healthcare Provider Details

I. General information

NPI: 1891093167
Provider Name (Legal Business Name): HAND & ORTHOPEDIC REHABILITATION SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11762 S STATE ST #120
DRAPER UT
84020-7155
US

IV. Provider business mailing address

5151 S 900 E 100
SALT LAKE CITY UT
84117-6657
US

V. Phone/Fax

Practice location:
  • Phone: 801-501-8359
  • Fax: 801-501-8360
Mailing address:
  • Phone: 801-261-3321
  • Fax: 801-261-5942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARGO JONES BRADY
Title or Position: OWNER/THERAPIST
Credential: PT CHT
Phone: 801-501-8359