Organization
PURE LIFE HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJ YERGENSEN (ADMIN)
(435) 986-9369
Entity
Organization
Contact information
Practice address
617 E RIVERSIDE DR STE 104, ST GEORGE, UT 84790-8720
(801) 638-7826
Mailing address
617 E RIVERSIDE DR STE 104, ST GEORGE, UT 84790-8720
(801) 638-7826
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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