MEDICARE: ULRICH GEORG KNORR 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	3406887100	UT

General Provider Information

NPI Number	:	1326119959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ULRICH GEORG KNORR ND

Provider Business Mailing Address
First Line	:	2188 SOUTH HIGHLAND DRIVE
Second Line	:	207
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2188 SOUTH HIGHLAND DRIVE
Second Line	:	207 EASTSIDE NATIONAL HEALTH CLINIC
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106
Country	:	US
Telephone Number	:	801-474-3684
Fax Number	:	801-474-3604

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	11/06/2014

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