Individual
MICHAEL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPSS
Contact information
Practice address
3269 S MAIN ST STE 100, SOUTH SALT LAKE, UT 84115-3773
(385) 213-0574
Mailing address
3269 S MAIN ST STE 100, SOUTH SALT LAKE, UT 84115-3773
(385) 213-0574
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
F24-114162
UT
Other
Enumeration date
10/23/2025
Last updated
10/23/2025
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