# MOTERUM SPECIALTY SERVICES LLC

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

## Provider details

- **NPI number:** 1467022863
- **Authorized official:** DAVID HUIZENGA (MANAGER)
- **Authorized official phone:** (678) 592-3447

## Contact information

- **Practice address:** 2757 S 300 W, SOUTH SALT LAKE, UT 84115-2933
- **Practice address phone:** (678) 592-3447
- **Mailing address:** 2757 S 300 W, SOUTH SALT LAKE, UT 84115-2933

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | — | — |
| 2081P0301X | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P0301X | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 06/28/2021
- **Last updated:** 07/06/2021