Organization
MTD MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN FROHSE KOEHLER MD (MANAGER)
(435) 716-5489
Entity
Organization
Contact information
Practice address
290 N RED SLIDE DR, WELLSVILLE, UT 84339-9757
(435) 716-5489
(435) 716-5442
Mailing address
290 N RED SLIDE DR, WELLSVILLE, UT 84339-9757
(435) 716-5489
(435) 716-5442
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
180791-1205
UT
Other
Enumeration date
02/18/2010
Last updated
01/26/2011
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