Basic Information
| Provider Information | |||||||||
| NPI: | 1164481008 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAWCHUK | ||||||||
| FirstName: | TERRY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5770 SOUTH 250 EAST | ||||||||
| Address2: | SUITE 135 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841078241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013142225 | ||||||||
| FaxNumber: | 8013142345 | ||||||||
| Practice Location | |||||||||
| Address1: | 5770 SOUTH 250 EAST | ||||||||
| Address2: | SUITE 135 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841078241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013142225 | ||||||||
| FaxNumber: | 8013142345 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2006 | ||||||||
| LastUpdateDate: | 11/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 182275-1205 | UT | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.