Healthcare Provider Details
I. General information
NPI: 1568765303
Provider Name (Legal Business Name): VALTON N. KING, D.O., LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/17/2010
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
839 E 1200 S
OREM UT
84097-6603
US
IV. Provider business mailing address
PO BOX 970190
OREM UT
84097-0190
US
V. Phone/Fax
- Phone: 801-224-0891
- Fax: 801-224-0891
- Phone: 801-224-0891
- Fax: 801-224-7100
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VALTON
NOBLE
KING
Title or Position: OWNER
Credential: D.O.
Phone: 801-224-0891