Organization
SERAPHINE MED TAYLORSVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WENDELL GNEITING FNP (MANAGING MEMBER)
(801) 966-9907
Entity
Organization
Contact information
Practice address
6126 SOUTH REDWOOD ROAD, TAYLORSVILLE, UT 84123
(801) 966-9907
(801) 966-0298
Mailing address
PO BOX 71218, SALT LAKE CITY, UT 84171-0218
(801) 966-9907
(801) 966-0298
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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