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General NPI Number Information
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NPI Number | 1558148429
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Entity Type | Organization
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Legal Business Name | PEAK HEALTH LLC
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 1635 N 200 E
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City | NORTH LOGAN
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State | UT
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Zip | 84341-1913
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Country | US
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Telephone | 620-397-3442
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Fax |
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Provider Business Mailing Address
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Address Line | 1635 N 200 E
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City | NORTH LOGAN
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State | UT
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Zip | 84341-1913
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Country | US
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Telephone | 620-397-3442
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JUSTEN WATKINS
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Credential | DO
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Telephone | 620-397-3442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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