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General NPI Number Information
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NPI Number | 1366806440
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Entity Type | Organization
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Legal Business Name | SLEEP AND BREATHE SPECIALISTS
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 4063 W 12600 S # SABS
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City | RIVERTON
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State | UT
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Zip | 84096-7302
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Country | US
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Telephone | 801-935-8180
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Fax | 801-931-2307
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Provider Business Mailing Address
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Address Line | 4063 W 12600 S # SABS
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City | RIVERTON
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State | UT
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Zip | 84096-7302
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Country | US
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Telephone | 801-935-8180
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Fax | 801-931-2307
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARRETT REED BIRD
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Credential | MD, CM
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Telephone | 801-935-8180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 8200519-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 8200519-1205
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License Number State | UT
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