MEDICARE: HARRY ADELSON ND

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	175F00000X	Naturopath	5160749-7100	UT

General Provider Information

NPI Number	:	1245273861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARRY ADELSON ND

Provider Business Mailing Address
First Line	:	PO BOX 463
Second Line	:
City	:	COALVILLE
State	:	UT
Zip	:	84017-0463
Country	:	US
Telephone Number	:	801-582-3260
Fax Number	:	801-484-2606

Provider Business Practice Location Address
First Line	:	2188 SOUTH HIGHLAND DRIVE
Second Line	:	STE 210
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106
Country	:	US
Telephone Number	:	801-582-3260
Fax Number	:	801-484-2606

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/08/2007

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