Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Spine and Sports Medicine Inc

Organization Sports Medicine (Neuromusculoskeletal Medicine) Physician · NPI 1073677845

Spine and Sports Medicine Inc provides Sports Medicine (Neuromusculoskeletal Medicine) Physician services in West Valley City, Utah. Licensed in Utah. Registered with an NPI since 2006.

Licensed in
UT
In the registry since
2006
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3336 Pioneer Pkwy Ste 204
West Valley City, UT 84120-2000
Phone: (801) 964-3249
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Pain Medicine Physician (primary) Taxonomy 208VP0014X · Licence 6053003-1204 (UT)
Sports Medicine (Neuromusculoskeletal Medicine) Physician Taxonomy 204C00000X · Licence 6053003-1204 (UT)
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X · Licence 185699 (UT)

Record details

NPI number1073677845
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Bova — President · (435) 640-6220
NPI enumeratedDecember 19, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address3065 Oak Rim Ln, Park City, UT 84060-6804