Provider Demographics
NPI:1679747224
Name:WASATCH PEAK, P.C.
Entity type:Organization
Organization Name:WASATCH PEAK, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:J
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:801-825-8091
Mailing Address - Street 1:1492 W ANTELOPE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-1139
Mailing Address - Country:US
Mailing Address - Phone:801-825-8091
Mailing Address - Fax:801-825-8142
Practice Address - Street 1:1492 W ANTELOPE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1139
Practice Address - Country:US
Practice Address - Phone:801-825-8091
Practice Address - Fax:801-825-8142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1212642401261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy