Grange, Timothy S

Grange, Timothy S is an individual health care provider with primary practice located at 4052 Pioneer Pkwy Suite 208, Salt Lake City UT 84120-2062. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Grange, Timothy S can be contacted via phone (801) 955-1232.

Contact Information

Primary practice address
4052 Pioneer Pkwy Suite 208 Salt Lake City UT 84120-2062
Fax: (801) 955-1543
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 891801521205 Utah

Profile Details

NPI number 1932169430
LBN Legal business name Grange, Timothy S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Jul 3rd, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932169430 NPPES
Utah Other 891801521205 UTAH STATE ID

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