Healthcare Provider Details

I. General information

NPI: 1831461698
Provider Name (Legal Business Name): EAST WEST HEALTH SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 S 500 E STE 202
SALT LAKE CITY UT
84102-1094
US

IV. Provider business mailing address

34 S 500 E STE 202
SALT LAKE CITY UT
84102-1094
US

V. Phone/Fax

Practice location:
  • Phone: 801-582-2011
  • Fax: 801-532-4710
Mailing address:
  • Phone: 801-582-2011
  • Fax: 801-532-4710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8255186-1202
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number5743144-1201
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number6592169-1205
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number8185054-1205
License Number StateUT
# 5
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number6272172-4405
License Number StateUT

VIII. Authorized Official

Name: REGAN J. ARCHIBALD
Title or Position: PRESIDENT
Credential: LAC
Phone: 801-582-2011