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NPI Code Detail

MEDICARE: SARIAH KOONTZ

MEDICARE: SARIAH KOONTZ
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
1225800000XRecreation Therapist1401807-4003UT

General Provider Information

NPI Number : 1548081599
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARIAH KOONTZ
Provider Business Mailing Address
First Line : 3743 ORCHARD AVE
Second Line :
City : SOUTH OGDEN
State : UT
Zip : 84403-1805
Country : US
Telephone Number : 435-494-8445
Fax Number :
Provider Business Practice Location Address
First Line : 1481 E 1450 S
Second Line :
City : CLEARFIELD
State : UT
Zip : 84015-1610
Country : US
Telephone Number : 435-494-8445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2024
Last Update Date : 10/22/2024

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Directions to “ SARIAH KOONTZ ” Practice Location

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