Healthcare Provider Details
I. General information
NPI: 1447387519
Provider Name (Legal Business Name): ROCKY MOUNTAIN WOMEN'S HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2007
Last Update Date: 07/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1580 W ANTELOPE DR STE 290
LAYTON UT
84041-1179
US
IV. Provider business mailing address
PO BOX 844839
DALLAS TX
75284-4839
US
V. Phone/Fax
- Phone: 801-776-0880
- Fax: 801-773-7399
- Phone: 877-210-9143
- Fax: 314-432-9683
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HOLDEN
U
HOLT
Title or Position: COO
Credential:
Phone: 801-776-0880