Healthcare Provider Details

I. General information

NPI: 1861272775
Provider Name (Legal Business Name): TAYLOR COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2023
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 E 250 S HPER WEST, ROOM 113
SALT LAKE CITY UT
84112
US

IV. Provider business mailing address

3130 E 1250 N
LAYTON UT
84040-3006
US

V. Phone/Fax

Practice location:
  • Phone: 801-585-1820
  • Fax:
Mailing address:
  • Phone: 801-300-0726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: