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Organization

SUPERIOR HEALTHCARE OF SPANISH FORK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRENT NEPHI WALL D.C. (PRESIDENT)
(801) 798-2515
Entity
Organization

Contact information

Practice address
750 N MAIN ST, SPANISH FORK, UT 84660-1147
(801) 798-2515
(801) 798-2510
Mailing address
750 N MAIN ST, SPANISH FORK, UT 84660-1147
(801) 798-2515
(801) 798-2510

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5129809-4405
UT

Other

Enumeration date
06/07/2012
Last updated
06/07/2012
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