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General NPI Number Information
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NPI Number | 1649161704
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Entity Type | Individual
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Provider Name | KADE WHITTLE
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Gender | Male
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 401 S 400 E
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City | BOUNTIFUL
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State | UT
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Zip | 84010-4933
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Country | US
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Telephone | 801-295-2361
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Fax |
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Provider Business Mailing Address
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Address Line | 5333 S BEACON HILL CIR
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City | TAYLORSVILLE
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State | UT
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Zip | 84123-4805
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Country | US
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Telephone | 801-574-4070
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 8881690-4202
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License Number State | UT
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