Provider Demographics
NPI:1801131156
Name:WASATCH PAIN AND HORMONE
Entity type:Organization
Organization Name:WASATCH PAIN AND HORMONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-776-7246
Mailing Address - Street 1:1513 N HILL FIELD RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-2162
Mailing Address - Country:US
Mailing Address - Phone:801-776-7246
Mailing Address - Fax:801-776-7247
Practice Address - Street 1:1513 N HILL FIELD RD
Practice Address - Street 2:SUITE 5
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2162
Practice Address - Country:US
Practice Address - Phone:801-776-7246
Practice Address - Fax:801-776-7247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty