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General NPI Number Information
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NPI Number | 1922967934
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Entity Type | Individual
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Provider Name | KAITLIN LA
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Gender | Female
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 4568 S HIGHLAND DR STE 180
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City | SALT LAKE CITY
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State | UT
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Zip | 84117-4236
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Country | US
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Telephone | 801-251-0257
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Fax |
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Provider Business Mailing Address
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Address Line | 3074 W CHALK CREEK WAY
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-7969
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 142245782401
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License Number State | UT
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