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General NPI Number Information
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NPI Number | 1497928147
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Entity Type | Organization
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Legal Business Name | TOTAL CONCEPT HEALTH CARE
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 920 N 200 W SUITE A
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City | LOGAN
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State | UT
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Zip | 84321-3200
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Country | US
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Telephone | 435-750-0366
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Fax | 435-750-0377
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Provider Business Mailing Address
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Address Line | 920 N 200 W SUITE A
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City | LOGAN
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State | UT
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Zip | 84321-3200
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Country | US
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Telephone | 435-750-0366
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Fax | 435-750-0377
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Authorized Official
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Title or Position | DOCTOR AND EXECUTIVE CHEIF
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Name | DR. DANEE S YOUNG
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Credential | M.D.
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Telephone | 435-750-0366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 183608-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 183608-1205
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License Number State | UT
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