Healthcare Provider Details

I. General information

NPI: 1487446324
Provider Name (Legal Business Name): KINDLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5097 S 900 E STE 100
MURRAY UT
84117-5725
US

IV. Provider business mailing address

5097 S 900 E STE 100
MURRAY UT
84117-5725
US

V. Phone/Fax

Practice location:
  • Phone: 801-851-5554
  • Fax: 833-464-2575
Mailing address:
  • Phone: 801-851-5554
  • Fax: 833-464-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AJ YERGENSEN
Title or Position: ADMIN
Credential: MBA
Phone: 435-986-9369