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NPI Code Detail

MEDICARE: SHANNON FELTS

MEDICARE: SHANNON FELTS
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
1225X00000XOccupational Therapist6647359-4201UT

General Provider Information

NPI Number : 1508188574
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON FELTS
Provider Business Mailing Address
First Line : 1050 E SOUTH TEMPLE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1507
Country : US
Telephone Number : 801-350-4111
Fax Number : 801-350-4522
Provider Business Practice Location Address
First Line : 24 W SERGEANT COURT DR STE 204
Second Line :
City : SARATOGA SPRINGS
State : UT
Zip : 84045-5809
Country : US
Telephone Number : 801-987-6333
Fax Number : 801-341-8724
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2010
Last Update Date : 01/13/2022

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Directions to “ SHANNON FELTS ” Practice Location

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