Provider Demographics
NPI:1558751438
Name:NATUROPATHIC MEDICAL, P.C.
Entity Type:Organization
Organization Name:NATUROPATHIC MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BREVAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:435-213-3029
Mailing Address - Street 1:565 W. 465 N.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332
Mailing Address - Country:US
Mailing Address - Phone:435-213-3029
Mailing Address - Fax:435-213-9591
Practice Address - Street 1:565 W. 465 N.
Practice Address - Street 2:SUITE 150
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332
Practice Address - Country:US
Practice Address - Phone:435-213-3029
Practice Address - Fax:435-213-9591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7730185-7100175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty