Healthcare Provider Details

I. General information

NPI: 1972469955
Provider Name (Legal Business Name): KANE COUNTY HOSPITAL HUMAN RESOURCE SPECIAL SERVICE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5648 ADAMS AVE PKWY
OGDEN UT
84405-7230
US

IV. Provider business mailing address

5648 ADAMS AVE PKWY
OGDEN UT
84405-7230
US

V. Phone/Fax

Practice location:
  • Phone: 801-475-0500
  • Fax: 801-475-0700
Mailing address:
  • Phone: 801-475-0500
  • Fax: 801-475-0700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SOON BURNAM
Title or Position: SECRETARY OF MANAGEMENT COMPANY
Credential:
Phone: 949-540-1249