Organization
CACHE VALLEY MEDICAL AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENITA JO QUAKENBUSH-ROBERTS PH.D. (CEO)
(435) 755-0434
Entity
Organization
Contact information
Practice address
196 S 100 W, LOGAN, UT 84321-5233
(435) 755-0434
(435) 755-0439
Mailing address
PO BOX 3443, LOGAN, UT 84323-3443
(435) 755-0434
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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