Healthcare Provider Details

I. General information

NPI: 1801049663
Provider Name (Legal Business Name): MINDNAUTILUS.COM CORPORATION DBA ENABLEMART
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 10/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 S 960 E STE 200
SALT LAKE CITY UT
84117-3576
US

IV. Provider business mailing address

5353 S 960 E STE 200
SALT LAKE CITY UT
84117-3576
US

V. Phone/Fax

Practice location:
  • Phone: 801-281-7677
  • Fax:
Mailing address:
  • Phone: 801-281-7677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. ISABEL PARKIN
Title or Position: ACCOUNTS RECEIVABLE
Credential:
Phone: 801-281-7677