Provider Demographics
NPI:1841919891
Name:JEFFERY, GARET (DAT, LAT, ATC)
Entity type:Individual
Prefix:DR
First Name:GARET
Middle Name:
Last Name:JEFFERY
Suffix:
Gender:M
Credentials:DAT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 N CENTER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7498
Mailing Address - Country:US
Mailing Address - Phone:801-592-9323
Mailing Address - Fax:
Practice Address - Street 1:510 CAVEMAN DR
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-1999
Practice Address - Country:US
Practice Address - Phone:801-592-9323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36003506A2255A2300X
UT12336931-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer