Provider Demographics
NPI:1841054533
Name:HARDIN, AMMON (LMT)
Entity type:Individual
Prefix:
First Name:AMMON
Middle Name:
Last Name:HARDIN
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 W 1800 S
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-7528
Mailing Address - Country:US
Mailing Address - Phone:801-636-6801
Mailing Address - Fax:
Practice Address - Street 1:4434 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:MILLCREEK
Practice Address - State:UT
Practice Address - Zip Code:84124-3533
Practice Address - Country:US
Practice Address - Phone:385-831-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7843084-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist