# ALPINE SPORTS MEDICINE LLC

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

## Provider details

- **NPI number:** 1982776530
- **Authorized official:** ANDREA P. TERWILLEGAR (PARTNER)
- **Authorized official phone:** (435) 645-9095

## Contact information

- **Practice address:** 2015 SIDEWINDER DR, PARK CITY, UT 84060-7323
- **Practice address phone:** (435) 645-9095
- **Practice address fax:** (435) 645-9092
- **Mailing address:** PO BOX 682226, PARK CITY, UT 84068-2226
- **Mailing address phone:** (435) 658-4691
- **Mailing address fax:** (435) 658-4691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 2832592401 | UT | — |
| 225100000X | Physical Therapist | 3296682401 | UT | Yes |
| 225100000X | Physical Therapist | 49452432401 | UT | — |
| 225100000X | Physical Therapist | 849822401 | UT | — |
| 225X00000X | Occupational Therapist | 2634904201 | UT | — |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 10/17/2014