Healthcare Provider Details

I. General information

NPI: 1871438804
Provider Name (Legal Business Name): MAPLE MOUNTAIN CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 S 1600 W STE 101
MAPLETON UT
84664-4346
US

IV. Provider business mailing address

36 S MAPLE LEAF DR
SPANISH FORK UT
84660-6231
US

V. Phone/Fax

Practice location:
  • Phone: 801-404-7622
  • Fax:
Mailing address:
  • Phone: 801-404-7622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KYLE SLEIGHT
Title or Position: OWNER/ PROVIDER
Credential: DNP
Phone: 801-404-7622