Healthcare Provider Details

I. General information

NPI: 1700128055
Provider Name (Legal Business Name): TONYA HARDY DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 03/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3081 S 5600 W
WEST VALLEY UT
84120-1303
US

IV. Provider business mailing address

4916 E 1250 S
HEBER CITY UT
84032-3659
US

V. Phone/Fax

Practice location:
  • Phone: 801-840-1858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number337736-2801
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: