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General NPI Number Information
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NPI Number | 1417773623
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Entity Type | Organization
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Legal Business Name | UTAH WOUND SOLUTIONS PLLC
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 450 S 400 E STE 724
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City | BOUNTIFUL
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State | UT
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Zip | 84010-4938
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Country | US
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Telephone | 385-262-3211
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Fax | 385-262-3211
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Provider Business Mailing Address
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Address Line | 450 S 400 E STE 724
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City | BOUNTIFUL
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State | UT
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Zip | 84010-4938
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Country | US
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Telephone | 385-262-3211
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Fax | 385-262-3211
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | BENJAMIN POPESCU
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Credential | PA
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Telephone | 385-262-3211
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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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