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General NPI Number Information
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NPI Number | 1821810581
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Entity Type | Individual
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Provider Name | TARA JOINER MPT
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Gender | Female
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 2295 S FOOTHILL DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84109-4000
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Country | US
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Telephone | 801-486-7542
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Fax |
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Provider Business Mailing Address
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Address Line | 68 GOSHAWK RANCH RD
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City | PARK CITY
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State | UT
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Zip | 84098-5529
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Country | US
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Telephone | 917-520-5086
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 12599179-2401
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License Number State | UT
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