Provider Demographics
NPI:1225647480
Name:KINDLY MD, INC.
Entity Type:Organization
Organization Name:KINDLY MD, INC.
Other - Org Name:UTAH THERAPEUTIC HEALTH CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-851-5554
Mailing Address - Street 1:5097 S 900 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CTY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5768
Mailing Address - Country:US
Mailing Address - Phone:801-851-5554
Mailing Address - Fax:833-464-2575
Practice Address - Street 1:5097 S 900 E STE 100
Practice Address - Street 2:
Practice Address - City:MILLCREEK
Practice Address - State:UT
Practice Address - Zip Code:84117-5725
Practice Address - Country:US
Practice Address - Phone:801-851-5554
Practice Address - Fax:833-464-2575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty