Healthcare Provider Details

I. General information

NPI: 1265157994
Provider Name (Legal Business Name): CLOSE TO YOU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 10/05/2022
Certification Date: 10/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 W 4000 N
PLEASANT VIEW UT
84414-1343
US

IV. Provider business mailing address

1229 W 4000 N
PLEASANT VIEW UT
84414-1343
US

V. Phone/Fax

Practice location:
  • Phone: 801-698-8850
  • Fax:
Mailing address:
  • Phone: 801-698-8850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY CARROLL
Title or Position: OWNER
Credential:
Phone: 801-698-8850