Organization
FLAGLIFE, INC
Active
Other names
Foot Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK T. POULTON C, PED (PRESIDENT/OWNER)
(435) 652-0100
Entity
Organization
Contact information
Practice address
362 W SAINT GEORGE BLVD, SAINT GEORGE, UT 84770-3352
(435) 652-0100
(435) 652-0103
Mailing address
362 W SAINT GEORGE BLVD, SAINT GEORGE, UT 84770-3352
(435) 652-0100
(435) 652-0103
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DESERET MUTUAL BENEF
DMBA MANAGED CARE PLAN
UT
Enumeration date
07/31/2006
Last updated
04/20/2008
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