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General NPI Number Information
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NPI Number | 1750998316
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Entity Type | Individual
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Provider Name | NICOLE CARLI GRAY DPT
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Gender | Female
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 6017 FASHION POINT DR
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City | SOUTH OGDEN
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State | UT
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Zip | 84403-4851
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Country | US
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Telephone | 801-317-1618
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Fax | 801-459-3707
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Provider Business Mailing Address
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Address Line | 5375 S 300 E
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City | WASHINGTON TERRACE
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State | UT
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Zip | 84405-6941
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Country | US
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Telephone | 801-726-9126
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11805453-8016
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License Number State | UT
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