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General NPI Number Information
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NPI Number | 1801879226
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Entity Type | Organization
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Legal Business Name | ALPINE MANAGEMENT AND CONSULTING
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 1030 MEDICAL DR STE A
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City | BRIGHAM CITY
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State | UT
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Zip | 84302-3276
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Country | US
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Telephone | 435-723-9700
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Fax | 435-787-1913
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Provider Business Mailing Address
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Address Line | 2310 N 400 E SUITE A
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City | LOGAN
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State | UT
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Zip | 84341-1788
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Country | US
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Telephone | 435-787-2000
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Fax | 435-787-1913
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Authorized Official
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Title or Position | PODIATRIST
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Name | SPENCER BOWEN HENINGER
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Credential | DPM
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Telephone | 435-787-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 5336197-0501
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State | UT
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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