Organization
MINDFUL MOBILE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER YOUNG (VP)
(801) 879-2664
Entity
Organization
Contact information
Practice address
623 E FORT UNION BLVD STE 105, MIDVALE, UT 84047-5529
(801) 879-2664
Mailing address
623 E FORT UNION BLVD STE 105, MIDVALE, UT 84047-5529
(385) 412-1660
(801) 261-5856
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/25/2024
Last updated
02/10/2025
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