Healthcare Provider Details

I. General information

NPI: 1245353879
Provider Name (Legal Business Name): WESTON A LINDSAY P.T., A.T., C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8TH AVE C ST
SALT LAKE CITY UT
84143-0001
US

IV. Provider business mailing address

8TH AVE C ST
SALT LAKE CITY UT
84143-0001
US

V. Phone/Fax

Practice location:
  • Phone: 801-408-2034
  • Fax:
Mailing address:
  • Phone: 801-408-2034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number5644494-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: