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General NPI Number Information
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NPI Number | 1245154038
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Entity Type | Individual
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Provider Name | SHEA SALLEE FNTP
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Gender | Male
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 11073 N ALPINE HWY STE 101
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City | HIGHLAND
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State | UT
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Zip | 84003-8933
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Country | US
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Telephone | 385-261-3064
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Fax |
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Provider Business Mailing Address
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Address Line | 11073 N ALPINE HWY
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City | HIGHLAND
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State | UT
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Zip | 84003-8927
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Country | US
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Telephone | 385-261-3064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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