Individual
ADAM ROBERT PERREAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, ATC
Contact information
Practice address
1500 KEARNS BLVD, PARK CITY, UT 84060-7226
(435) 714-9044
(435) 658-5241
Mailing address
PO BOX 680751, PARK CITY, UT 84068-0751
(435) 714-9044
(435) 658-5241
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001574-1
NY
2255A2300X
Athletic Trainer
7085752-4810
UT
Other
Enumeration date
03/27/2008
Last updated
04/09/2009
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