Moonlighting Inc | |
14728 Pristine Dr Draper UT 84020-7642 | |
(801) 599-3450 | |
Not Available |
Full Name | Moonlighting Inc |
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Speciality | Clinic/center - Community Health |
Location | 14728 Pristine Dr, Draper, Utah |
Authorized Official Name and Position | Layne Kilpatrick (PRESIDENT, CEO) |
Authorized Official Contact | 8015993450 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Moonlighting Inc Po Box 1344 Draper UT 84020-1344 Ph: () - | Moonlighting Inc 14728 Pristine Dr Draper UT 84020-7642 Ph: (801) 599-3450 |
NPI Number | 1366758591 |
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Provider Enumeration Date | 08/25/2010 |
Last Update Date | 08/25/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366758591 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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