Healthcare Provider Details

I. General information

NPI: 1902427636
Provider Name (Legal Business Name): LAURA TUTTLE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6272 S HIGHLAND DR STE 203
MURRAY UT
84121-2126
US

IV. Provider business mailing address

PO BOX 25537
SALT LAKE CITY UT
84125-0537
US

V. Phone/Fax

Practice location:
  • Phone: 801-871-6350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number160680
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0017161
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13461997-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: