# TMS ELEVATED

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

## Provider details

- **NPI number:** 1871101014
- **Authorized official:** MELISSA LOPEZ-LARSON MD (OWNER/PROVIDER)
- **Authorized official phone:** (385) 441-3004

## Contact information

- **Practice address:** 1790 SUN PEAK DR STE B105, PARK CITY, UT 84098-6625
- **Practice address phone:** (385) 441-3004
- **Practice address fax:** (435) 602-1131
- **Mailing address:** 1790 SUN PEAK DR STE B105, PARK CITY, UT 84098-6625
- **Mailing address phone:** (385) 441-3004
- **Mailing address fax:** (435) 602-1131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/14/2020
- **Last updated:** 07/14/2020