# PREMIER PROVIDER HEALTH UTAH PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Wound Integrity Utah
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699311209
- **Authorized official:** NORA LOPEZ (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (346) 239-9469

## Contact information

- **Practice address:** 5475 S 500 E, OGDEN, UT 84405-6905
- **Practice address phone:** (801) 479-2111
- **Mailing address:** 1 CHISHOLM TRAIL RD STE 5200, ROUND ROCK, TX 78681-5090
- **Mailing address phone:** (512) 202-3830
- **Mailing address fax:** (512) 354-1106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RI0200X | Infectious Disease Physician | — | NULL | — |
| 207RI0200X | Infectious Disease Physician | — | — | — |

## Other

- **Enumeration date:** 11/19/2019
- **Last updated:** 11/13/2024