Organization
PROVIDER SERVICES NETWORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL EWING (CEO)
(801) 845-2222
Entity
Organization
Contact information
Practice address
765 E 340 S STE 206, AMERICAN FORK, UT 84003-3310
(801) 893-1130
Mailing address
5513 W 11000 N # 535, HIGHLAND, UT 84003-8012
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10995695-0142
STATE OF UTAH
UT
Enumeration date
04/23/2020
Last updated
04/23/2020
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