Organization Name: | MARQUARDT PROFESSIONAL CORPORATION |
NPI Number: | 1467631507 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONALD NILAN MARQUARDT (PRESIDENT, MARQUARDT PROF CORP) |
Mailing Address: | 267 N Main St Moab |
State: | UT US |
Postal Code: | 845322342 |
Phone Number: | 4352595276 |
Fax Number: | 4352595277 |
NPI Enumeration Date: | 10/25/2007 |
NPI Last Update Date: | 10/25/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | 1623961205 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |