Organization
RESTORATIVE HEALTH PRIMARY CARE
Active
Organization
RESTORATIVE HEALTH PRIMARY CARE
Active
Other names
Restorative Health Primary Care & Ketamine
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BEESLEY (PARTNER)
(385) 449-0565
Entity
Organization
Contact information
Practice address
850 E 9400 S STE 101, SANDY, UT 84094-4114
(385) 449-0565
Mailing address
850 E 9400 S STE 101, SANDY, UT 84094-4114
(385) 449-0565
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14053329
COUNCIL FOR AFFORDABLE QUALITY HEALTHCARE (CAQH) PROVIDER ID
UT
Enumeration date
07/09/2019
Last updated
07/09/2019
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