Diamond Springs Wellness Center PC
Family Medicine in Midway, UT. Organization (NPI-2).
NPI number1780980391
StatusActive
Last updated in NPPESJan 28, 2011
Details
- NPI
- 1780980391
- Entity type
- Organization (NPI-2)
- Legal business name
- Diamond Springs Wellness Center PC
- Organization subpart
- No
- Enumeration date
- Jan 28, 2011
- Last updated
- Jan 28, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 180388-1204 | UT | Yes |
Practice location
210 E Main StSuite 101
Midway, UT 84049-6806
Phone 435-657-1777 · Fax 435-657-0098
Mailing address
210 E Main StSuite 101
Midway, UT 84049-6806
Phone 435-657-1777 · Fax 435-657-0098
Authorized official
Judith S Moore
Owner
4356571777
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