Provider Demographics
NPI:1982957809
Name:MCGUIRE, ERICA DAWN (ATC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:DAWN
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1988 W 80 S
Mailing Address - Street 2:#3
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-6841
Mailing Address - Country:US
Mailing Address - Phone:805-750-0669
Mailing Address - Fax:
Practice Address - Street 1:1988 WEST 80 SOUTH
Practice Address - Street 2:#3
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-6841
Practice Address - Country:US
Practice Address - Phone:805-750-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7441813-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer