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General NPI Number Information
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NPI Number | 1477081412
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Entity Type | Organization
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Legal Business Name | ALTA CANYON SPINE LLC
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 5911 S FASHION BLVD STE 200
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City | MURRAY
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State | UT
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Zip | 84107-7210
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Country | US
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Telephone | 385-541-2225
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Fax | 855-541-2200
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Provider Business Mailing Address
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Address Line | 5911 S FASHION BLVD STE 200
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City | MURRAY
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State | UT
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Zip | 84107-7210
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Country | US
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Telephone | 855-412-2253
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Fax | 385-541-2200
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Authorized Official
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Title or Position | MD
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Name | JUSTIN BURNELL HOHL
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Credential | MD
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Telephone | 385-541-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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