Provider Demographics
NPI:1356910269
Name:HAUPT, ALEXANDER (DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:HAUPT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:JAMES LEWIS
Other - Middle Name:ALEXANDER
Other - Last Name:HAUPT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:555 E 3635 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-1111
Mailing Address - Country:US
Mailing Address - Phone:435-901-0275
Mailing Address - Fax:
Practice Address - Street 1:1794 OLYMPIC PKWY STE 140
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-6389
Practice Address - Country:US
Practice Address - Phone:435-575-0345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12298218-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist