Healthcare Provider Details

I. General information

NPI: 1205765203
Provider Name (Legal Business Name): CONNER G EYRE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 E RIVERSIDE DR STE 104
ST GEORGE UT
84790-7141
US

IV. Provider business mailing address

585 E RIVERSIDE DR STE 104
ST GEORGE UT
84790-7141
US

V. Phone/Fax

Practice location:
  • Phone: 435-673-4303
  • Fax:
Mailing address:
  • Phone: 435-673-4303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14286813-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: