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Contact Information

ISA5417, LLC
154 E MYRTLE AVE STE 100
MURRAY, UT84107-4850
 Phone: 801-210-5050
 Fax: 801-210-5050
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation

111NR0400X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for ISA5417 LLC · (Female)

NPI Number 1063176170
Status Active
Credentials
Entity Individual
Enumeration date 10/25/2021
Last updated 11/09/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
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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