Provider Demographics
NPI:1700506284
Name:GARIZIO, SCOTT JOHN (MSWI)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:JOHN
Last Name:GARIZIO
Suffix:
Gender:M
Credentials:MSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 W 1428 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-7391
Mailing Address - Country:US
Mailing Address - Phone:385-204-1535
Mailing Address - Fax:
Practice Address - Street 1:566 W 1428 S
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-7391
Practice Address - Country:US
Practice Address - Phone:385-204-1535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program