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General NPI Number Information
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NPI Number | 1396682258
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Entity Type | Organization
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Legal Business Name | INTEGRATED FUNCTIONAL MEDICINE
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 4624 S HOLLADAY BLVD STE 202
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City | SALT LAKE CITY
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State | UT
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Zip | 84117-7168
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Country | US
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Telephone | 385-800-5015
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Fax | 801-277-6678
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Provider Business Mailing Address
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Address Line | 458 N 500 W
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City | BOUNTIFUL
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State | UT
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Zip | 84010-6948
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT FROGLEY
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Credential | DC
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Telephone | 801-816-0332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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