Provider Demographics
NPI:1619653789
Name:KOW HOLDINGS LLC
Entity Type:Organization
Organization Name:KOW HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RISTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-305-9014
Mailing Address - Street 1:345 W 600 S STE 118
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-2283
Mailing Address - Country:US
Mailing Address - Phone:435-305-9014
Mailing Address - Fax:
Practice Address - Street 1:228 E 6400 S
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7305
Practice Address - Country:US
Practice Address - Phone:801-263-9125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center