Provider Demographics
NPI:1265110126
Name:VINEIZ-COX, ELIHU JOHN (LMT)
Entity type:Individual
Prefix:
First Name:ELIHU
Middle Name:JOHN
Last Name:VINEIZ-COX
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 E 1350 S APT E105
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-2659
Mailing Address - Country:US
Mailing Address - Phone:385-465-5569
Mailing Address - Fax:
Practice Address - Street 1:1290 S 500 W # 5
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84010-8100
Practice Address - Country:US
Practice Address - Phone:385-465-5569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12546180-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist