MEDICARE: INTEGRATED WELLNESS UTAH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1164176731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED WELLNESS UTAH, LLC

Provider Business Mailing Address
First Line	:	34 S 500 E STE 202
Second Line	:
City	:	SLC
State	:	UT
Zip	:	84102-1094
Country	:	US
Telephone Number	:	801-582-2011
Fax Number	:	801-582-2011

Provider Business Practice Location Address
First Line	:	34 S 500 E STE 202
Second Line	:
City	:	SLC
State	:	UT
Zip	:	84102-1094
Country	:	US
Telephone Number	:	801-582-2011
Fax Number	:	801-582-2011

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	LAURA HILL
Credential	:
Telephone Number	:	801-860-9404

Provider Enumeration Date	:	02/11/2022
Last Update Date	:	04/12/2022

Similar Medicare Providers

1952368839 — JOHN U LAWRENCE MD
Practice Location Address:

34 S 500 E , STE 202
SLC, UT
84102-1094

Practice Phone: 801-582-2011
Practice Fax:

1164623765 — REGAN JAY ARCHIBALD LAC.
Practice Location Address:

34 S 500 E STE 103
SALT LAKE CITY, UT
84102-1094

Practice Phone: 801-582-2011
Practice Fax: 801-359-8478

1730476755 — RYAN MICHAEL KILLARNEY L.AC.
Practice Location Address:

34 S 500 E STE 202
SALT LAKE CITY, UT
84102-1094

Practice Phone: 801-582-2011
Practice Fax:

1831461698 — EAST WEST HEALTH SOLUTIONS INC
Practice Location Address:

34 S 500 E STE 202
SALT LAKE CITY, UT
84102-1094

Practice Phone: 801-582-2011
Practice Fax: 801-532-4710

1073120606 — JENSEN EYRE CHES
Practice Location Address:

34 S 500 E STE 202
SALT LAKE CITY, UT
84102-1094

Practice Phone: 801-582-2011
Practice Fax: 801-582-2011

1285216374 — VANESSA L MOCK MAOM, L.AC.
Practice Location Address:

34 S 500 E STE 202
SALT LAKE CITY, UT
84102-1094

Practice Phone: 801-582-2011
Practice Fax:

Directions to “INTEGRATED WELLNESS UTAH, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.