Healthcare Provider Details

I. General information

NPI: 1649381401
Provider Name (Legal Business Name): TERRY MICHAEL GUTHRIE AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 WOODLAND PARK DR STE 220
LAYTON UT
84041-5620
US

IV. Provider business mailing address

1536 WOODLAND PARK DR STE 220
LAYTON UT
84041-5620
US

V. Phone/Fax

Practice location:
  • Phone: 801-682-4089
  • Fax: 801-217-6266
Mailing address:
  • Phone: 801-682-4089
  • Fax: 801-217-6266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number14225346-4101
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number50527
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number50527
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: