Organization
ACQUA MEDICAL LLC
Active
Organization
ACQUA MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLINT TOLMAN (ADMINISTRATIVE DIRECTOR)
(844) 654-3700
Entity
Organization
Contact information
Practice address
100 N JOHNSON MILL RD, MIDWAY, UT 84049-6764
(844) 654-3700
(801) 926-1133
Mailing address
1031 S DOUGLAS ST, SALT LAKE CITY, UT 84105-1505
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
293281-1205
UT
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
Other
Enumeration date
03/29/2017
Last updated
06/20/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up