Healthcare Provider Details

I. General information

NPI: 1518524511
Provider Name (Legal Business Name): ASPYN MADSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2019
Last Update Date: 05/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W CENTER ST STE 201
LOGAN UT
84321-5803
US

IV. Provider business mailing address

2240 N HWY 89 STE C
HARRISVILLE UT
84404-2824
US

V. Phone/Fax

Practice location:
  • Phone: 801-393-6232
  • Fax: 801-393-4081
Mailing address:
  • Phone: 801-393-6232
  • Fax: 801-393-4081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: