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General NPI Number Information
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NPI Number | 1184293136
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Entity Type | Organization
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Legal Business Name | ONSITE ADVANCED CARE
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 3356 W 775 N
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City | LAYTON
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State | UT
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Zip | 84041-8801
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Country | US
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Telephone | 801-941-9889
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Fax |
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Provider Business Mailing Address
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Address Line | 3356 W 775 N
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City | LAYTON
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State | UT
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Zip | 84041-8801
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Country | US
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Telephone | 801-638-0400
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DEDRA LEINBACH
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Credential |
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Telephone | 801-638-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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