Summit Wellness Clinic LLC
Integrative Medicine in Draper, UT. Organization (NPI-2).
NPI number1053099366
StatusActive
Last updated in NPPESJul 6, 2023
Details
- NPI
- 1053099366
- Entity type
- Organization (NPI-2)
- Legal business name
- Summit Wellness Clinic LLC
- Organization subpart
- No
- Enumeration date
- Jul 6, 2023
- Certification date
- Jul 6, 2023
- Last updated
- Jul 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 202D00000X | Integrative Medicine | – | – | Yes |
| 111N00000X | Chiropractor | – | – | |
| 225700000X | Massage Therapist | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Practice location
12397 S 300 E Ste 200Draper, UT 84020-8274
Phone 801-758-0225
Mailing address
12397 S 300 E Ste 200Draper, UT 84020-8274
Phone 801-702-0386
Authorized official
Kimberly Kercher Glasgow
Managing Member
8017020386
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Integrative Medicine Physician providers in Draper, UT
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.