Provider Demographics
NPI:1760847552
Name:POLISHED HOLDINGS, INC.
Entity Type:Organization
Organization Name:POLISHED HOLDINGS, INC.
Other - Org Name:AGELESS MEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MELSSIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCCLELLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-451-7305
Mailing Address - Street 1:491 W. BOURNE CIRCLE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025
Mailing Address - Country:US
Mailing Address - Phone:801-451-7305
Mailing Address - Fax:801-451-7303
Practice Address - Street 1:491 W. BOURNE CIRCLE
Practice Address - Street 2:SUITE 2
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025
Practice Address - Country:US
Practice Address - Phone:801-451-7305
Practice Address - Fax:801-451-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty