| Wasatch Back Wellness, Pllc | |
|
906 S Main St Heber City UT 84032-2403 | |
| (435) 654-3032 | |
| Not Available |
| Full Name | Wasatch Back Wellness, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 906 S Main St, Heber City, Utah |
| Authorized Official Name and Position | Stephen C. Frogley (OWNER) |
| Authorized Official Contact | 4355035492 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wasatch Back Wellness, Pllc 2394 Charros Rd Sandy UT 84092-4817 Ph: (435) 503-5492 | Wasatch Back Wellness, Pllc 906 S Main St Heber City UT 84032-2403 Ph: (435) 654-3032 |
| NPI Number | 1629306790 |
|---|---|
| Provider Enumeration Date | 11/30/2009 |
| Last Update Date | 11/30/2009 |
| Medicare PECOS PAC ID | 6002959848 |
|---|---|
| Medicare Enrollment ID | O20100202000830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629306790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5850450-1202 (Utah) | Primary |
| Provider Name | Stephen C Frogley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1992032270 PECOS PAC ID: 4385787126 Enrollment ID: I20100202000815 |
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