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Contact Information

ULTIMATE SPORTS REGENERATIVE MEDICINE
1098 W. SOUTH JORDAN PKWY
SUITE 101
SOUTH JORDAN, UT84095
 Phone: 801-254-5800
 Fax: 801-254-1696
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Independent Medical Examiner

111NI0013X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for ULTIMATE SPORTS REGENERATIVE MEDICINE · (Female)

NPI Number 1366989931
Status Active
Credentials
Entity Individual
Enumeration date 01/20/2017
Last updated 01/20/2017 - About 9 years ago
Sole proprietor 1 Not specified
Identifiers
  • UT License # 347183-4405
  • UT License # 7058178-1202
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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