| Page Speiser L C S W P C | |
|
275 E South Temple Ste 101 Salt Lake City UT 84111-1243 | |
| (801) 531-7389 | |
| (801) 364-1433 |
| Full Name | Page Speiser L C S W P C |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 275 E South Temple Ste 101, Salt Lake City, Utah |
| Authorized Official Name and Position | Page Speiser (PRESIDENT) |
| Authorized Official Contact | 8015317389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Page Speiser L C S W P C 275 E South Temple Ste 101 Salt Lake City UT 84111-1243 Ph: (801) 531-7389 | Page Speiser L C S W P C 275 E South Temple Ste 101 Salt Lake City UT 84111-1243 Ph: (801) 531-7389 |
| NPI Number | 1770879470 |
|---|---|
| Provider Enumeration Date | 06/22/2011 |
| Last Update Date | 10/26/2017 |
| Medicare PECOS PAC ID | 5294036216 |
|---|---|
| Medicare Enrollment ID | O20171219003258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770879470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 138965-3501 (Utah) | Primary |
| Provider Name | Page Speiser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104928654 PECOS PAC ID: 4385902410 Enrollment ID: I20171220002167 |
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