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NPI Code Detail

MEDICARE: MRS. CARLA MAGPANTAY RIDING

MEDICARE: MRS. CARLA MAGPANTAY RIDING
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 Therapist130669104003UT

General Provider Information

NPI Number : 1952153926
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARLA MAGPANTAY RIDING
Provider Business Mailing Address
First Line : 165 S 1000 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1402
Country : US
Telephone Number : 385-478-5485
Fax Number :
Provider Business Practice Location Address
First Line : 165 S 1000 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1402
Country : US
Telephone Number : 385-478-5485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2024
Last Update Date : 04/03/2024

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Directions to “ MRS. CARLA MAGPANTAY RIDING ” Practice Location

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