Organization
GRAND COUNTY WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY ALLEN ANDREW M.D. (OWNER)
(435) 259-4466
Entity
Organization
Contact information
Practice address
255 WILLIAMS WAY, MOAB, UT 84532-2370
(435) 259-4466
(435) 259-4467
Mailing address
255 WILLIAMS WAY, MOAB, UT 84532
(435) 259-4466
(435) 259-4467
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5141202-1205
STATE LICENSE NUMBER
UT
Enumeration date
12/19/2006
Last updated
03/07/2023
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