Individual
ELISE SHANTHANI VADIVELOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14787 S ACADEMY PKWY, HERRIMAN, UT 84096-2077
(385) 434-3118
Mailing address
152 E MIDVILLAGE BLVD APT 209, SANDY, UT 84070-1375
(385) 464-7942
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14212533-2401
UT
Other
Enumeration date
12/13/2025
Last updated
12/13/2025
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