Healthcare Provider Details

I. General information

NPI: 1942923545
Provider Name (Legal Business Name): ALEXANDER L HARRINGTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 09/20/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 E 250 S HPER WEST 113
SALT LAKE CITY UT
84112-8411
US

IV. Provider business mailing address

250 S MARIO CAPECCHI DR # 607B
SALT LAKE CITY UT
84112-5800
US

V. Phone/Fax

Practice location:
  • Phone: 801-585-1820
  • Fax:
Mailing address:
  • Phone: 808-463-4885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: