Individual
MRS. TYSHA WOODS CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
3000 N CENTER ST, LEHI, UT 84043-4400
(801) 413-8300
Mailing address
788 E 8230 S, SANDY, UT 84094-0679
(801) 413-8300
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
10866759-4810
UT
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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