Organization · NPI-2

1 Source 211 Services

Preventive Medicine, Public Health & General Preventive Medicine · Salt Lake City, UT

NPI number1407536766
StatusActive
Last updated in NPPESJun 22, 2024

Details

NPI
1407536766
Entity type
Organization (NPI-2)
Legal business name
1 Source 211 Services
Organization subpart
No
Enumeration date
Jul 21, 2023
Certification date
Jun 22, 2024
Last updated
Jun 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine––Yes

Other names

  • We Source (Former Legal Business Name)

Practice location

955 E 200 S
Salt Lake City, UT 84102-2432

Phone 702-462-0067

Mailing address

Po Box 633
Salt Lake City, UT 84110-0633

Phone 702-462-0067

Authorized official

Taundria R Duncan
Public Service Administrator
7024620067

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