Healthcare Provider Details

I. General information

NPI: 1083547269
Provider Name (Legal Business Name): KARLIE VALDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N 850 E STE D
LEHI UT
84043-8623
US

IV. Provider business mailing address

1517 S 430 W # 1517
OREM UT
84058-7371
US

V. Phone/Fax

Practice location:
  • Phone: 801-702-8475
  • Fax:
Mailing address:
  • Phone: 801-791-0657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14288252-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: