Organization
THISTLE CREEK RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETH RIDDLE M.D. (OWNER)
(801) 362-4900
Entity
Organization
Contact information
Practice address
14048 SOUTH HIGHWAY 89, SPANISH FORK, UT 84660
(801) 873-3199
(801) 873-3507
Mailing address
PO BOX 542, SPANISH FORK, UT 84660-0542
(801) 873-3199
(801) 873-3507
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
4381
UT
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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