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General NPI Number Information
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NPI Number | 1225895022
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Entity Type | Organization
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Legal Business Name | OQUIRRH SERVICES
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 3390 W SIGNAL PEAK DR # 121
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City | TAYLORSVILLE
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State | UT
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Zip | 84129-3910
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Country | US
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Telephone | 385-346-3860
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Fax |
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Provider Business Mailing Address
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Address Line | 3390 W SIGNAL PEAK DR # 121
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City | TAYLORSVILLE
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State | UT
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Zip | 84129-3910
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Country | US
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Telephone | 385-346-3860
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIK REAVELEY
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Credential |
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Telephone | 385-346-3860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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