Provider Demographics
NPI:1033269618
Name:GOLDFINE, LAURA RENE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:RENE
Last Name:GOLDFINE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8767 HIDDEN OAK DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6128
Mailing Address - Country:US
Mailing Address - Phone:801-942-6445
Mailing Address - Fax:
Practice Address - Street 1:THE ORTHOPEDIC SPECIALTY HOSPITAL
Practice Address - Street 2:5848 S. FASHION BLVD.
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107
Practice Address - Country:US
Practice Address - Phone:801-314-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4931385-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer