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NPI Code Detail

MEDICARE: PETER LONERGAN

MEDICARE: PETER LONERGAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-21-195510UT

General Provider Information

NPI Number : 1477211498
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER LONERGAN
Provider Business Mailing Address
First Line : 8031 S 700 E
Second Line :
City : SANDY
State : UT
Zip : 84070-0555
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8031 S 700 E
Second Line :
City : SANDY
State : UT
Zip : 84070-0555
Country : US
Telephone Number : 385-695-2203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2021
Last Update Date : 12/07/2021

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Directions to “ PETER LONERGAN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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