Organization
WADE FAMILY MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH D WADE D.O. (PRESIDENT)
(801) 298-9155
Entity
Organization
Contact information
Practice address
557 W 2600 S, BOUNTIFUL, UT 84010-7747
(801) 298-9155
(801) 298-9156
Mailing address
557 W 2600 S, BOUNTIFUL, UT 84010-7747
(801) 298-9155
(801) 298-9156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
180211-1204
UT
Other
Enumeration date
06/01/2009
Last updated
09/16/2009
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