Provider Demographics
NPI:1245273861
Name:ADELSON, HARRY (ND)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:ADELSON
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 463
Mailing Address - Street 2:
Mailing Address - City:COALVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84017-0463
Mailing Address - Country:US
Mailing Address - Phone:801-582-3260
Mailing Address - Fax:801-484-2606
Practice Address - Street 1:2188 SOUTH HIGHLAND DRIVE
Practice Address - Street 2:STE 210
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106
Practice Address - Country:US
Practice Address - Phone:801-582-3260
Practice Address - Fax:801-484-2606
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5160749-7100175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath