Healthcare Provider Details

I. General information

NPI: 1457761884
Provider Name (Legal Business Name): HEPFREE2, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 05/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6671 S REDWOOD RD STE 110
WEST JORDAN UT
84084-7491
US

IV. Provider business mailing address

2616 E COMMONWEALTH AVE
SALT LAKE CITY UT
84109-1312
US

V. Phone/Fax

Practice location:
  • Phone: 801-815-2437
  • Fax: 844-437-3733
Mailing address:
  • Phone: 801-815-2437
  • Fax: 844-437-3733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateUT

VIII. Authorized Official

Name: MRS. CHER STRUCK
Title or Position: CEO
Credential:
Phone: 801-815-2437