Organization
WASATCH G O D MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYREE KNIGHT (MANAGER)
(385) 612-1794
Entity
Organization
Contact information
Practice address
2480 S MAIN ST STE 108, SOUTH SALT LAKE, UT 84115-5002
(385) 612-1794
Mailing address
2480 S MAIN ST STE 108, SOUTH SALT LAKE, UT 84115-5002
(385) 612-1794
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
11/11/2025
Last updated
11/11/2025
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