Organization
ADVANCED PAIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAWNA H GOULDING (OFFICE ADMINISTRATOR)
(801) 409-2044
Entity
Organization
Contact information
Practice address
6028 S RIDGELINE DR, SUITE 101, OGDEN, UT 84405-6914
(801) 409-2044
(801) 475-4948
Mailing address
6028 S RIDGELINE DR, SUITE 101, OGDEN, UT 84405-6914
(801) 409-2044
(801) 475-4948
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
6414842-1204
UT
Other
Enumeration date
08/18/2011
Last updated
08/18/2011
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