Healthcare Provider Details

I. General information

NPI: 1982770756
Provider Name (Legal Business Name): ALICE N COVEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 M STATE STREET
OREM UT
84057-2025
US

IV. Provider business mailing address

1790 M STATE STREET
OREM UT
84057-2025
US

V. Phone/Fax

Practice location:
  • Phone: 801-224-8255
  • Fax: 801-224-8301
Mailing address:
  • Phone: 801-224-8255
  • Fax: 801-224-8301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number60424994901
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: