Provider Demographics
NPI:1881428266
Name:SCHENCK, ALLI LYNN
Entity type:Individual
Prefix:
First Name:ALLI
Middle Name:LYNN
Last Name:SCHENCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 S 1300 E STE 300
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3613
Mailing Address - Country:US
Mailing Address - Phone:435-272-3408
Mailing Address - Fax:
Practice Address - Street 1:724 E 2100 S STE B
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-3026
Practice Address - Country:US
Practice Address - Phone:801-487-0499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program