Provider Demographics
NPI:1821734880
Name:GINOCCHIO CONSULTING
Entity Type:Organization
Organization Name:GINOCCHIO CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:OWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GINOCCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:801-616-2446
Mailing Address - Street 1:230 N 1680 E BLDG W
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2579
Mailing Address - Country:US
Mailing Address - Phone:435-705-8737
Mailing Address - Fax:435-355-3801
Practice Address - Street 1:230 N 1680 E BLDG W
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2579
Practice Address - Country:US
Practice Address - Phone:435-705-8737
Practice Address - Fax:435-355-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care