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General NPI Number Information
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NPI Number | 1295995413
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Entity Type | Individual
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Provider Name | TRICIA LYNN CORCORAN L.AC., DIPL. OM
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Gender | Female
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 10382 S JORDAN GTWY STE 150
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-4190
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Country | US
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Telephone | 415-987-8147
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Fax | 888-972-4948
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Provider Business Mailing Address
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Address Line | 11422 S LAKE RUN RD
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City | SOUTH JORDAN
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State | UT
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Zip | 84009-8716
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Country | US
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Telephone | 415-987-8147
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Fax | 888-972-4948
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 11940180-1201
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License Number State | UT
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