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Contact Information

SPINE AND SPORTS MEDICINE INC
3336 PIONEER PKWY
SUITE 204
WEST VALLEY CITY, UT84120-2000
 Phone: 801-964-3249
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Neuromusculoskeletal Medicine, Sports Medicine

204C00000X 12 Physician/Osteopathic Manipulative Medicine
 

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for SPINE AND SPORTS MEDICINE INC · (Female)

NPI Number 1073677845
Status Active
Credentials
Entity Individual
Enumeration date 12/19/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • UT License # 185699
  • UT License # 6053003-1204
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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