| Anodyne Of Southern Utah Llc | |
|
393 E Riverside Dr Ste 2b St George UT 84790-7048 | |
| (435) 773-7790 | |
| (435) 627-3917 |
| Full Name | Anodyne Of Southern Utah Llc |
|---|---|
| Speciality | General Practice |
| Location | 393 E Riverside Dr Ste 2b, St George, Utah |
| Authorized Official Name and Position | Greg Simons (CEO) |
| Authorized Official Contact | 4357737790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anodyne Of Southern Utah Llc 393 E Riverside Dr Ste 2b St George UT 84790-7048 Ph: (435) 773-7790 | Anodyne Of Southern Utah Llc 393 E Riverside Dr Ste 2b St George UT 84790-7048 Ph: (435) 773-7790 |
| NPI Number | 1396405122 |
|---|---|
| Provider Enumeration Date | 12/20/2021 |
| Last Update Date | 12/20/2021 |
| Medicare PECOS PAC ID | 9234522970 |
|---|---|
| Medicare Enrollment ID | O20220202000703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396405122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jeffrey Laray Gale |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114418167 PECOS PAC ID: 0446506810 Enrollment ID: I20210226002456 |
| Provider Name | Satin Marie Condos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528718293 PECOS PAC ID: 2961872411 Enrollment ID: I20221228001405 |
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