Individual
MR. DAVID L WETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
12403 S DOREEN DR, RIVERTON, UT 84065-4360
(801) 448-1770
(801) 877-5356
Mailing address
12403 S DOREEN DR, RIVERTON, UT 84065-4360
(801) 448-1770
(801) 877-5356
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22-106687-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001
CIGNA ID
UT
01
—
107009210101
IHC ID
UT
01
—
3109
PEHP ID
UT
01
—
870357748
TAX ID
UT
01
—
QMXAF
ALTIUS ID
UT
Enumeration date
06/09/2005
Last updated
04/03/2023
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