Individual
SCOTT HICKENLOOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7005
Mailing address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8674042-2401
UT
Other
Enumeration date
06/14/2013
Last updated
06/14/2013
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