Organization
ALPINE MANAGEMENT AND CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER BOWEN HENINGER DPM (PODIATRIST)
(435) 787-2000
Entity
Organization
Contact information
Practice address
1030 MEDICAL DR STE A, BRIGHAM CITY, UT 84302-3276
(435) 723-9700
(435) 787-1913
Mailing address
2310 N 400 E, SUITE A, LOGAN, UT 84341-1788
(435) 787-2000
(435) 787-1913
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
UT
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
UT
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
5336197-0501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5166950002
DME PTAN
UT
Enumeration date
11/21/2005
Last updated
10/04/2018
Update your record
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