Healthcare Provider Details

I. General information

NPI: 1982553053
Provider Name (Legal Business Name): MEGAN LEIGH PALES TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S 1850 E
SALT LAKE CITY UT
84112-0920
US

IV. Provider business mailing address

8872 S SUMMER MEADOW DR
SANDY UT
84093-1491
US

V. Phone/Fax

Practice location:
  • Phone: 636-578-1048
  • Fax:
Mailing address:
  • Phone:
  • 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: