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NPI 1821487885

NPI 1821487885 : KATHERINE HUGHES ATC : SALT LAKE CITY, UT

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General NPI Number Information
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    NPI Number           |    1821487885
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    Entity Type          |    Individual 
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    Provider Name        |    KATHERINE HUGHES ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/14/2015
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    Last Update Date     |    01/14/2015
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Provider Practice Location Address
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    Address Line         |    1825 E SOUTHCAMPUS DR 
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    City                 |    SALT LAKE CITY
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    State                |    UT
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    Zip                  |    84112-0900
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    Country              |    US
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    Telephone            |    801-587-9085
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    701 N DE SOTO ST 
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    City                 |    SALT LAKE CITY
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    State                |    UT
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    Zip                  |    84103-2138
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    Country              |    US
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    Telephone            |    
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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       |    8689217-4810
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    License Number State |    UT
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