Organization
EVOLVE EMOD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW WINAKOR (MEMBER)
(516) 807-9324
Entity
Organization
Contact information
Practice address
5965 S 900 E STE 255, SALT LAKE CITY, UT 84121-1872
(844) 438-7577
Mailing address
5965 S 900 E STE 255, SALT LAKE CITY, UT 84121-1872
(844) 438-7577
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
171WH0202X
Home Modifications Contractor
Primary
—
—
171WV0202X
Vehicle Modifications Contractor
—
—
333300000X
Emergency Response System Companies
—
—
372500000X
Chore Provider
—
—
Other
Enumeration date
07/15/2014
Last updated
07/24/2024
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