| Organization Name: | MED ONE MEDICAL |
| NPI Number: | 1194723650 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL R TREACY (OWNER) |
| Mailing Address: | 6965 Union Park Ctr #400 Midvale |
| State: | UT US |
| Postal Code: | 840476008 |
| Phone Number: | 8015666433 |
| Fax Number: | 8013040076 |
| NPI Enumeration Date: | 07/08/2005 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1200X |
| License Number: | 17686 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Sleep Disorder Diagnostic |
| Taxonomy Definition: | |