Healthcare Provider Details

I. General information

NPI: 1548867625
Provider Name (Legal Business Name): CAROLYN S JUNGE LMT, CFMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N MEDICAL DR
SALT LAKE CITY UT
84113-1105
US

IV. Provider business mailing address

910 S DONNER WAY APT 301
SALT LAKE CITY UT
84108-4119
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-0098
  • Fax:
Mailing address:
  • Phone: 801-835-2274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number11168202-4701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: