# SUMMIT WELLNESS CLINIC LLC

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

## Provider details

- **NPI number:** 1053099366
- **Authorized official:** KIMBERLY KERCHER GLASGOW DC (MANAGING MEMBER)
- **Authorized official phone:** (801) 702-0386

## Contact information

- **Practice address:** 12397 S 300 E STE 200, DRAPER, UT 84020-8274
- **Practice address phone:** (801) 758-0225
- **Mailing address:** 12397 S 300 E STE 200, DRAPER, UT 84020-8274
- **Mailing address phone:** (801) 702-0386

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 202D00000X | Integrative Medicine Physician | — | NULL | Yes |
| 202D00000X | Integrative Medicine Physician | — | — | Yes |
| 225700000X | Massage Therapist | — | NULL | — |
| 225700000X | Massage Therapist | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/06/2023
- **Last updated:** 07/06/2023