Healthcare Provider Details

I. General information

NPI: 1225895022
Provider Name (Legal Business Name): OQUIRRH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3390 W SIGNAL PEAK DR # 121
TAYLORSVILLE UT
84129-3910
US

IV. Provider business mailing address

3390 W SIGNAL PEAK DR # 121
TAYLORSVILLE UT
84129-3910
US

V. Phone/Fax

Practice location:
  • Phone: 385-346-3860
  • Fax:
Mailing address:
  • Phone: 385-346-3860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: ERIK REAVELEY
Title or Position: OWNER
Credential:
Phone: 385-346-3860