Organization
MINDFUL HEALING LLC
Active
Other names
Southwick Integrative Healing
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA SOUTHWICK NURSE PRACTITIONER (OWNER/EMPLOYEE)
(801) 432-7712
Entity
Organization
Contact information
Practice address
8541 S REDWOOD RD STE C2, WEST JORDAN, UT 84088
(801) 432-7712
Mailing address
8541 S REDWOOD RD STE C2, WEST JORDAN, UT 84088-9323
(801) 432-7712
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200020-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017129
—
UT
Enumeration date
06/01/2018
Last updated
08/17/2018
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