OrganizationActive
Tms Elevated
NPI 1871101014 · Child & Adolescent Psychiatry Physician · Park City, UT
Provider details
- NPI number
- 1871101014
- Entity type
- Organization
- Primary specialty
- Child & Adolescent Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Melissa Lopez-Larson, Owner/Provider(385) 441-3004
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1790 Sun Peak Dr Ste B105
Park City, UT 84098-6625
Phone: (385) 441-3004
Fax: (435) 602-1131
Approximate (ZIP-level) locationGet directions
Mailing address
1790 Sun Peak Dr Ste B105
Park City, UT 84098-6625
Registry dates
- Enumerated
- 2020-07-14
- Last updated
- 2020-07-14
- Certified
- 2020-07-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.