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Organization
KETAMINE WELLNESS CENTERS S L C
Active
Organization
KETAMINE WELLNESS CENTERS S L C
Active
Parent organization
KETAMINE WELLNESS CENTERS ARIZONA LLC
Other names
Ketamine Wellness Centers
Organization subpart
Yes
Provider details
NPI number
Legal business name
KETAMINE WELLNESS CENTERS ARIZONA LLC
Authorized official
MS. ANITA JERGER (EXECUTIVE ASSISTANT)
(480) 788-8539
Entity
Organization
Contact information
Practice address
6087 S REDWOOD RD STE B, TAYLORSVILLE, UT 84123-6854
(855) 538-3555
Mailing address
6087 S REDWOOD RD STE B, TAYLORSVILLE, UT 84123-6854
(855) 538-9355
(844) 538-9355
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
07/28/2022
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