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General NPI Number Information
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NPI Number | 1528502788
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Entity Type | Organization
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Legal Business Name | ORN INDUSTRIES, LLC
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Dates
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Enumeration Date | 12/07/2016
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 722 SHEPARD LN STE 102
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City | FARMINGTON
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State | UT
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Zip | 84025-3845
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Country | US
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Telephone | 801-388-5129
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Fax |
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Provider Business Mailing Address
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Address Line | 722 SHEPARD LN STE 102
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City | FARMINGTON
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State | UT
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Zip | 84025-3845
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Country | US
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Telephone | 801-388-5129
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MR. HANS C JENKINS
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Credential | DO
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Telephone | 602-501-0143
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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 | 8017616-1204
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License Number State | UT
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