Kimberly Davis Integrativehealth Pllc | |
1174 E Graystone Way Ste 15 Salt Lake City UT 84106-2678 | |
(801) 486-0875 | |
(801) 606-7230 |
Full Name | Kimberly Davis Integrativehealth Pllc |
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Speciality | Clinic/Center |
Location | 1174 E Graystone Way Ste 15, Salt Lake City, Utah |
Authorized Official Name and Position | Kimberly Jo Davis (DOCTOR) |
Authorized Official Contact | 8014860875 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kimberly Davis Integrativehealth Pllc 1174 E Graystone Way Ste 15 Salt Lake City UT 84106-2678 Ph: (801) 486-0875 | Kimberly Davis Integrativehealth Pllc 1174 E Graystone Way Ste 15 Salt Lake City UT 84106-2678 Ph: (801) 486-0875 |
NPI Number | 1881020774 |
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Provider Enumeration Date | 09/24/2013 |
Last Update Date | 05/28/2024 |
Medicare PECOS PAC ID | 3779706353 |
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Medicare Enrollment ID | O20140529001003 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881020774 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Kimberly J Davis |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487820320 PECOS PAC ID: 5890849913 Enrollment ID: I20090824000465 |
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