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General NPI Number Information
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NPI Number | 1770905705
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Entity Type | Organization
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Legal Business Name | EMERE UTAH, LLC
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 5296 S COMMERCE DR SUITE 104
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City | MURRAY
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State | UT
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Zip | 84107-4767
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Country | US
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Telephone | 385-474-8888
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Fax | 801-590-8123
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Provider Business Mailing Address
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Address Line | PO BOX 1468
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City | BOUNTIFUL
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State | UT
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Zip | 84011-1468
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Country | US
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Telephone | 801-296-2113
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Fax | 801-296-1715
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Authorized Official
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Title or Position | CEO
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Name | ALAN COTTLE
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Credential |
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Telephone | 801-617-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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