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General NPI Number Information
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NPI Number | 1699732123
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Entity Type | Organization
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Legal Business Name | JORDAN RIVER WOMEN'S HEALTH, P.C.
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3584 W 9000 S STE 206
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City | WEST JORDAN
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State | UT
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Zip | 84088-5710
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Country | US
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Telephone | 801-561-2227
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Fax | 801-561-5353
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Provider Business Mailing Address
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Address Line | 3584 W 9000 S STE 206
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City | WEST JORDAN
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State | UT
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Zip | 84088-5710
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Country | US
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Telephone | 801-561-2227
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Fax | 801-561-5353
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TAZMA SHAW
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Credential |
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Telephone | 801-561-2227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | UT
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