Organization
MOONLIGHTING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAYNE KILPATRICK RPH (PRESIDENT, CEO)
(801) 599-3450
Entity
Organization
Contact information
Practice address
14728 PRISTINE DR, DRAPER, UT 84020-7642
(801) 599-3450
Mailing address
PO BOX 1344, DRAPER, UT 84020-1344
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/25/2010
Last updated
08/25/2010
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