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General NPI Number Information
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NPI Number | 1457761884
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Entity Type | Organization
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Legal Business Name | HEPFREE2, LLC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 6671 S REDWOOD RD STE 110
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City | WEST JORDAN
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State | UT
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Zip | 84084-7491
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Country | US
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Telephone | 801-815-2437
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Fax | 844-437-3733
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Provider Business Mailing Address
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Address Line | 2616 E COMMONWEALTH AVE
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City | SALT LAKE CITY
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State | UT
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Zip | 84109-1312
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Country | US
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Telephone | 801-815-2437
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Fax | 844-437-3733
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Authorized Official
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Title or Position | CEO
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Name | MRS. CHER STRUCK
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Credential |
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Telephone | 801-815-2437
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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 | UT
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