Organization
METAMORPHOSIS OGDEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON M. TERWEDO M.P.A., FACHE (PRESIDENT)
(801) 622-5272
Entity
Organization
Contact information
Practice address
2144 WASHINGTON BLVD, OGDEN, UT 84401-1420
(801) 622-5272
Mailing address
2557 LINCOLN AVENUE, OGDEN, UT 84401
(801) 622-5272
(801) 622-5256
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
6264391-8913
UT
Other
Enumeration date
11/07/2006
Last updated
08/06/2015
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