Organization · NPI-2

Utah Sports And Orthopedics

Orthopaedic Surgery, Sports Medicine · Sandy, UT

NPI number1790402170

StatusActive

Last updated in NPPESOct 26, 2022

Details

NPI: 1790402170
Entity type: Organization (NPI-2)
Legal business name: Utah Sports And Orthopedics
Organization subpart: No
Enumeration date: Oct 26, 2022
Certification date: Oct 26, 2022
Last updated: Oct 26, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207XX0005X	Orthopaedic Surgery, Sports Medicine	–	–	Yes
207RS0010X	Internal Medicine, Sports Medicine	–	–
2080S0010X	Pediatrics, Sports Medicine	–	–
2081S0010X	Physical Medicine & Rehabilitation, Sports Medicine	–	–
2083S0010X	Preventive Medicine, Sports Medicine	–	–
2251S0007X	Physical Therapist, Sports	–	–
133VN1501X	Dietitian, Registered, Nutrition, Sports Dietetics	–	–
204C00000X	Neuromusculoskeletal Medicine, Sports Medicine	–	–
207PS0010X	Emergency Medicine, Sports Medicine	–	–
207QS0010X	Family Medicine, Sports Medicine	–	–

Practice location

2516 E Snow Mountain Dr
Sandy, UT 84093-1858

Phone 801-410-0205

Mailing address

2516 E Snow Mountain Dr
Sandy, UT 84093-1858

Authorized official

Kevin Mangum
Ceo
8014100205

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.