MEDICARE: DIANA WEIL CNS, CD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133N00000X	Nutritionist	13786725-4901	UT

General Provider Information

NPI Number	:	1902610983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA WEIL CNS, CD

Provider Business Mailing Address
First Line	:	222 E COATSVILLE AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-1927
Country	:	US
Telephone Number	:	801-910-4285
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 E COATSVILLE AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-1927
Country	:	US
Telephone Number	:	801-910-4285
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2025
Last Update Date	:	02/01/2025

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