# SERAPHINE MED TAYLORSVILLE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013153311
- **Authorized official:** MR. ROBERT WENDELL GNEITING FNP (MANAGING MEMBER)
- **Authorized official phone:** (801) 966-9907

## Contact information

- **Practice address:** 6126 SOUTH REDWOOD ROAD, TAYLORSVILLE, UT 84123
- **Practice address phone:** (801) 966-9907
- **Practice address fax:** (801) 966-0298
- **Mailing address:** PO BOX 71218, SALT LAKE CITY, UT 84171-0218
- **Mailing address phone:** (801) 966-9907
- **Mailing address fax:** (801) 966-0298

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/17/2008
- **Last updated:** 12/17/2008