Individual
SOTERO LEON PERIGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
280 RIVER PARK DR, PROVO, UT 84604-5764
(801) 928-8436
Mailing address
1128 S 2450 W, SYRACUSE, UT 84075-7051
(801) 928-8436
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
11027022-4810
UT
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2017
Last updated
10/18/2021
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