Healthcare Provider Details

I. General information

NPI: 1831616630
Provider Name (Legal Business Name): READ FITNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 08/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6556 S BIG COTTONWOOD CANYON RD
SALT LAKE CTY UT
84121-3580
US

IV. Provider business mailing address

6556 S BIG COTTONWOOD CANYON RD
SALT LAKE CTY UT
84121-3580
US

V. Phone/Fax

Practice location:
  • Phone: 435-553-5698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: TAYLA RUSSELL
Title or Position: DIETITIAN
Credential:
Phone: 435-553-5698