# LIFESTYLE HEARING OF UTAH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205250966
- **Authorized official:** MR. JOHN RALPH PATER M.A.,AAA (CLINICAL AUDIOLOGIST)
- **Authorized official phone:** (801) 417-9696

## Contact information

- **Practice address:** 2964 W 4700 S, SUITE 116, SALT LAKE CITY, UT 84129-2557
- **Practice address phone:** (801) 417-9696
- **Practice address fax:** (801) 417-9697
- **Mailing address:** 2964 W 4700 S, SUITE 116, SALT LAKE CITY, UT 84129-2557
- **Mailing address phone:** (801) 417-9696
- **Mailing address fax:** (801) 417-9697

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 103915-4101 | UT | Yes |

## Other

- **Enumeration date:** 02/14/2014
- **Last updated:** 02/14/2014