Intermountain Senior Care Services, Llc

NPI 1114289980 - Nurse Practitioner - 363LA2200X

NPI Details
NPI 1114289980
Enumeration Date 06/08/2012
Last Updated 04/30/2014
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name MARK L MARK
Position PRESIDENT / CEO
Phone (435) 862-6143
Fax (435) 635-4506
Practice Location
616 S RIVER RD
SUITE 200
ST GEORGE UT, 84790-2104, US
Phone (435) 862-6143
Fax (435) 635-4506
Business Location
PO BOX 910855
ST GEORGE UT, 84791-0855, US
Phone (435) 862-6143
Fax (435) 635-4506
Toxanomy
Taxonomy Code 363LA2200X
License State
License Number
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According to our database, Intermountain Senior Care Services, Llc NPI is 1114289980, taxonomy code is 363LA2200X Intermountain Senior Care Services, Llc physically located at 616 S River Rd, St George UT, 84790-2104. NPI Number 1033115704 has the healthcare provider type.

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1114289980 NPI number is provided on an as is basis without warranty of any kind. 1114289980 is maintained by the National Plan & Provider Enumeration System. The contents of Intermountain Senior Care Services, Llc are for informational purposes only.