Provider Demographics
NPI:1699599696
Name:DIAMOND, WENDY C (PT, DPT)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:C
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 S RIVER VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-6613
Mailing Address - Country:US
Mailing Address - Phone:919-619-3294
Mailing Address - Fax:
Practice Address - Street 1:354 W CROSSROADS BLVD
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-5506
Practice Address - Country:US
Practice Address - Phone:801-341-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14157732-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist