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General NPI Number Information
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NPI Number | 1568937381
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Entity Type | Individual
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Provider Name | DANIEL PAUL CARPENTER ATC
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Gender | Male
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 10/08/2018
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Provider Practice Location Address
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Address Line | 3580 S 3600 W
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City | WEST VALLEY CITY
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State | UT
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Zip | 84119-2645
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Country | US
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Telephone | 385-646-5320
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Fax |
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Provider Business Mailing Address
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Address Line | 7430 N COTTAGE LN
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City | EAGLE MOUNTAIN
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State | UT
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Zip | 84005-4895
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Country | US
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Telephone | 435-590-7015
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 9874945-4810
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License Number State | UT
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