Brain Body Balance Treatment Centers
Psychiatry & Neurology, Psychiatry in Saint George, UT. Organization (NPI-2).
NPI number1164095022
StatusActive
Last updated in NPPESNov 16, 2021
Details
- NPI
- 1164095022
- Entity type
- Organization (NPI-2)
- Legal business name
- Brain Body Balance Treatment Centers
- Organization subpart
- No
- Enumeration date
- Jul 20, 2021
- Certification date
- Nov 16, 2021
- Last updated
- Nov 16, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | Yes |
| 163WP0808X | Registered Nurse, Psych/Mental Health | – | – |
Practice location
640 E 700 S Ste 205aSaint George, UT 84770-4023
Phone 435-767-8840 · Fax 435-359-5120
Mailing address
640 E 700 S Ste 205aSaint George, UT 84770-4023
Phone 435-767-8840 · Fax 435-359-5120
Authorized official
Forrest Jim Wolverton
Owner
4357678840
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