Provider Demographics
NPI:1710467485
Name:ROCKWOOD, HAILEY ELIZABETH (MS, ATC/L)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:ELIZABETH
Last Name:ROCKWOOD
Suffix:
Gender:F
Credentials:MS, ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5690 KINGSFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-6309
Mailing Address - Country:US
Mailing Address - Phone:435-714-0607
Mailing Address - Fax:
Practice Address - Street 1:1840 S 1300 E
Practice Address - Street 2:PAYNE GYMNASIUM RM 105
Practice Address - City:SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84105
Practice Address - Country:US
Practice Address - Phone:435-714-0607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10878993-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer