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General NPI Number Information
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NPI Number | 1083905244
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Entity Type | Organization
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Legal Business Name | WORK CARE-NORTH, LLC
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Dates
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Enumeration Date | 04/22/2011
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Last Update Date | 04/22/2011
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Provider Practice Location Address
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Address Line | 2084 N 1700 W #D
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City | LAYTON
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State | UT
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Zip | 84041-1194
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Country | US
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Telephone | 801-773-3400
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Fax | 801-773-3401
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Provider Business Mailing Address
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Address Line | PO BOX 271395
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City | SALT LAKE CITY
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State | UT
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Zip | 84126-0692
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Country | US
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Telephone | 801-773-3400
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Fax | 801-773-3401
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARK V ANDERSON
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Credential | MD
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Telephone | 801-975-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | UT
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