Organization Name: | WASATCH PEAK FAMILY PRACTICE INC |
NPI Number: | 1790998359 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYNETTE CHOWNING (OFFICE MANAGER) |
Mailing Address: | 1580 W Antelope Dr Suite 200 Layton |
State: | UT US |
Postal Code: | 840411160 |
Phone Number: | 8017734770 |
Fax Number: | 8017734776 |
NPI Enumeration Date: | 05/08/2007 |
NPI Last Update Date: | 05/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |