Healthcare Provider Details

I. General information

NPI: 1417312299
Provider Name (Legal Business Name): ALISHA BATY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISHA MECHAM DPT

II. Dates (important events)

Enumeration Date: 12/22/2015
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 W 400 N ST 2
DREM UT
84057
US

IV. Provider business mailing address

527 W 400 N ST 2
DREM UT
84057
US

V. Phone/Fax

Practice location:
  • Phone: 801-714-3505
  • Fax:
Mailing address:
  • Phone: 801-714-3505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9249039-2401
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number9249039-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: