Individual
TYLER SOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6246 S REDWOOD RD, SALT LAKE CITY, UT 84123-6600
(801) 969-1420
Mailing address
206 N 2100 W, SALT LAKE CITY, UT 84116-4740
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9073240-4202
UT
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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