Healthcare Provider Details

I. General information

NPI: 1366806440
Provider Name (Legal Business Name): SLEEP AND BREATHE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4063 W 12600 S # SABS
RIVERTON UT
84096-7302
US

IV. Provider business mailing address

4063 W 12600 S # SABS
RIVERTON UT
84096-7302
US

V. Phone/Fax

Practice location:
  • Phone: 801-935-8180
  • Fax: 801-931-2307
Mailing address:
  • Phone: 801-935-8180
  • Fax: 801-931-2307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number8200519-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number8200519-1205
License Number StateUT

VIII. Authorized Official

Name: DR. GARRETT REED BIRD
Title or Position: OWNER
Credential: MD, CM
Phone: 801-935-8180