Provider Demographics
NPI:1225895022
Name:OQUIRRH SERVICES
Entity Type:Organization
Organization Name:OQUIRRH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPECKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:385-337-1144
Mailing Address - Street 1:4133 W PIONEER PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-2059
Mailing Address - Country:US
Mailing Address - Phone:385-337-1144
Mailing Address - Fax:888-546-0632
Practice Address - Street 1:4133 W PIONEER PKWY STE 130
Practice Address - Street 2:
Practice Address - City:WEST VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84120-2059
Practice Address - Country:US
Practice Address - Phone:385-337-1144
Practice Address - Fax:888-546-0632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty