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General NPI Number Information
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NPI Number | 1376343061
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Entity Type | Individual
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Provider Name | GABRIELLE PEARSON LMT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 70 E HAWTHORNE HILL LN # 70
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City | DRAPER
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State | UT
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Zip | 84020-3409
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Country | US
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Telephone | 435-879-1440
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Fax |
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Provider Business Mailing Address
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Address Line | 1787 E FORT UNION BLVD
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City | COTTONWOOD HEIGHTS
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State | UT
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Zip | 84121-2850
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Country | US
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Telephone | 801-883-8203
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 10668612-4701
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License Number State | UT
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