Healthcare Provider Details

I. General information

NPI: 1013323377
Provider Name (Legal Business Name): CHRISTOPHER SEUL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 07/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5848 S 300 E
MURRAY UT
84107-6121
US

IV. Provider business mailing address

1551 W RIVERDALE RD APT C15
RIVERDALE UT
84405-3205
US

V. Phone/Fax

Practice location:
  • Phone: 801-314-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: