Provider Demographics
NPI:1285036632
Name:MCELHENNEY, SADIE ANN
Entity type:Individual
Prefix:
First Name:SADIE
Middle Name:ANN
Last Name:MCELHENNEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:SADIE
Other - Middle Name:ANN
Other - Last Name:FILLMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 25537
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0537
Mailing Address - Country:US
Mailing Address - Phone:435-657-4690
Mailing Address - Fax:
Practice Address - Street 1:380 E 1500 S STE 102
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-3941
Practice Address - Country:US
Practice Address - Phone:435-657-4690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9638792-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist