Healthcare Provider Details

I. General information

NPI: 1306779384
Provider Name (Legal Business Name): LINDSEY TERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 S DENVER ST STE 350
SALT LAKE CITY UT
84111-3059
US

IV. Provider business mailing address

513 E MINT GREEN CIR
MURRAY UT
84107-3944
US

V. Phone/Fax

Practice location:
  • Phone: 801-949-9444
  • Fax: 801-666-6149
Mailing address:
  • Phone: 801-949-9444
  • Fax: 801-666-6149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: