Organization
CANYON FOOT AND ANKLE LLC
Active
Parent organization
CANYON FOOT AND ANKLE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CANYON FOOT AND ANKLE LLC
Authorized official
LEVI BERRY DPM (OWNER)
(801) 609-4743
Entity
Organization
Contact information
Practice address
607 KIRBY LN STE D, SPANISH FORK, UT 84660-1368
(801) 609-4743
(801) 804-5545
Mailing address
83 E 1200 N, MAPLETON, UT 84664-3710
(801) 609-4743
(801) 804-5545
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
93570600501
UT
332B00000X
Durable Medical Equipment & Medical Supplies
93570600501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659748952
GROUP NPI
UT
Enumeration date
08/22/2015
Last updated
01/02/2025
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