Provider Demographics
NPI:1417918087
Name:GARRETT, LAYNE MATTHEW (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAYNE
Middle Name:MATTHEW
Last Name:GARRETT
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 E 300 N
Mailing Address - Street 2:SUITE C
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-1790
Mailing Address - Country:US
Mailing Address - Phone:801-763-0724
Mailing Address - Fax:801-763-8282
Practice Address - Street 1:321 E 300 N
Practice Address - Street 2:SUITE C
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-1790
Practice Address - Country:US
Practice Address - Phone:801-763-0724
Practice Address - Fax:801-763-8282
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4769160-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005738801Medicare ID - Type UnspecifiedMEDICARE