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General NPI Number Information
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NPI Number | 1477281699
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Entity Type | Organization
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Legal Business Name | SUSTAINABLE HEALTHCARE
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 36 N 1100 E STE C
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2918
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Country | US
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Telephone | 801-836-2229
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Fax |
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Provider Business Mailing Address
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Address Line | 36 N 1100 E STE 3C
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2912
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE LEMKE
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Credential |
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Telephone | 801-836-2229
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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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