Healthcare Provider Details

I. General information

NPI: 1457913071
Provider Name (Legal Business Name): IN HOME ERGONOMICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 S STATE ST
SALT LAKE CITY UT
84115-3834
US

IV. Provider business mailing address

3080 S STATE ST
SALT LAKE CITY UT
84115-3834
US

V. Phone/Fax

Practice location:
  • Phone: 801-308-1144
  • Fax: 801-308-1145
Mailing address:
  • Phone: 801-308-1144
  • Fax: 801-308-1145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. DIONE MONTANO
Title or Position: VP OPERATIONS
Credential:
Phone: 801-308-1144