Healthcare Provider Details

I. General information

NPI: 1083531495
Provider Name (Legal Business Name): PHYSICAL MEDICINE AND REHABILITATION UTAH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E 3900 S
SALT LAKE CITY UT
84124-1300
US

IV. Provider business mailing address

1200 E 3900 S
SALT LAKE CITY UT
84124-1300
US

V. Phone/Fax

Practice location:
  • Phone: 801-268-7111
  • Fax:
Mailing address:
  • Phone: 801-268-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIELLA LAPLANTE
Title or Position: OWNER
Credential: MD
Phone: 385-645-4424