Individual
AMANDA LEIGH ELROD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, ATC/L
Contact information
Practice address
3690 S MAIN ST, SALT LAKE CITY, UT 84115-4423
(801) 587-2525
Mailing address
375 S CHIPETA WAY, SUITE A, SALT LAKE CITY, UT 84108-1260
(801) 581-7766
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
6312424-4810
UT
363A00000X
Physician Assistant
Primary
6312424-1206
UT
Other
Enumeration date
12/01/2009
Last updated
10/21/2021
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