Healthcare Provider Details

I. General information

NPI: 1487150728
Provider Name (Legal Business Name): SOUND SLEEP MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 07/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 EAST 700 SOUTH BUILDING 2
ST. GEORGE UT
84770
US

IV. Provider business mailing address

640 EAST 700 SOUTH BUILDING 2
ST. GEORGE UT
84770
US

V. Phone/Fax

Practice location:
  • Phone: 801-685-3225
  • Fax: 801-396-7031
Mailing address:
  • Phone: 801-685-3225
  • Fax: 801-396-7031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KIAYA WATSON
Title or Position: BUSINESS MANAGER
Credential:
Phone: 385-290-0992