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Organization
MOTERUM SPECIALTY SERVICES LLC
Active
Organization
MOTERUM SPECIALTY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HUIZENGA (MANAGER)
(678) 592-3447
Entity
Organization
Contact information
Practice address
2757 S 300 W, SOUTH SALT LAKE, UT 84115-2933
(678) 592-3447
Mailing address
2757 S 300 W, SOUTH SALT LAKE, UT 84115-2933
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
NULL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
06/28/2021
Last updated
07/06/2021
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