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General NPI Number Information
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NPI Number | 1184029639
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Entity Type | Organization
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Legal Business Name | HEALTH WATCH PROVO INC
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 1485 E 840 N
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City | OREM
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State | UT
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Zip | 84097-5486
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Country | US
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Telephone | 801-225-0599
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Fax |
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Provider Business Mailing Address
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Address Line | 9152 SILVER LAKE DR
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City | CEDAR HILLS
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State | UT
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Zip | 84062-8787
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Country | US
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Telephone | 801-225-0599
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KAYE LOPEZ
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Credential |
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Telephone | 801-225-9599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 2013-HHA-825
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License Number State | UT
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