IndividualActive
Graydon Wickman, ATC-L, LMT, CSS
NPI 1043612252 · Athletic Trainer · West Valley City, UT
Provider details
- NPI number
- 1043612252
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- ATC-L, LMT, CSS
- Sex
- Male
- Sole proprietor
- No
- License
- 514032-4810 (UT)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3336 S Pioneer Pkwy
Suite 101
West Valley City, UT 84120-2000
Phone: (801) 964-3100
Street-level locationGet directions
Mailing address
3336 S Pioneer Pkwy
West Valley City, UT 84120-2000
Registry dates
- Enumerated
- 2014-09-18
- Last updated
- 2014-09-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.