| Timber Ridge Holdings Llc | |
|
448 E 5350 S Ste B Washington Terrace UT 84405-5415 | |
| (801) 540-4564 | |
| Not Available |
| Full Name | Timber Ridge Holdings Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Clinical Neurophysiology |
| Location | 448 E 5350 S Ste B, Washington Terrace, Utah |
| Authorized Official Name and Position | Brian Pennocks (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8016981160 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Timber Ridge Holdings Llc 448 E 5350 S Ste B Washington Terrace UT 84405-5415 Ph: () - | Timber Ridge Holdings Llc 448 E 5350 S Ste B Washington Terrace UT 84405-5415 Ph: (801) 540-4564 |
| NPI Number | 1508098906 |
|---|---|
| Provider Enumeration Date | 08/18/2009 |
| Last Update Date | 08/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508098906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Primary |
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