Organization
IMPACT HEALTH & WELLNESS LLC
Active
Other names
Optimal Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MONSON (OWNER)
(801) 568-1598
Entity
Organization
Contact information
Practice address
193 E FORT UNION BLVD STE 203, MIDVALE, UT 84047-5543
(801) 568-1598
Mailing address
193 E FORT UNION BLVD STE 203, MIDVALE, UT 84047-5543
(801) 568-1598
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
07/26/2024
Last updated
07/26/2024
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