Organization · NPI-2

Aloha Ketamine And Wellness LLC

Family Medicine · Orem, UT

NPI number1477309581
StatusActive
Last updated in NPPESApr 29, 2024

Details

NPI
1477309581
Entity type
Organization (NPI-2)
Legal business name
Aloha Ketamine And Wellness LLC
Organization subpart
No
Enumeration date
Apr 29, 2024
Certification date
Apr 29, 2024
Last updated
Apr 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

720 N 530 E
Orem, UT 84097-4104

Phone 385-498-7506

Mailing address

720 N 530 E
Orem, UT 84097-4104

Authorized official

John Sanders
Owner
3854827991

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