| Generational Health Llc | |
|
1264 Village Main Dr Unit A West Valley City UT 84119-1952 | |
| (801) 972-0393 | |
| (801) 972-5707 |
| Full Name | Generational Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1264 Village Main Dr Unit A, West Valley City, Utah |
| Authorized Official Name and Position | Michael R Frogley (OWNER) |
| Authorized Official Contact | 8019720393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Generational Health Llc 1264 Village Main Dr Unit A West Valley City UT 84119-1952 Ph: (801) 972-0393 | Generational Health Llc 1264 Village Main Dr Unit A West Valley City UT 84119-1952 Ph: (801) 972-0393 |
| NPI Number | 1639356884 |
|---|---|
| Provider Enumeration Date | 01/29/2008 |
| Last Update Date | 02/18/2008 |
| Medicare PECOS PAC ID | 2264515048 |
|---|---|
| Medicare Enrollment ID | O20080218000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639356884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 6790232-1202 (Utah) | Primary |
| Provider Name | Steven C Lore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922090356 PECOS PAC ID: 0042289936 Enrollment ID: I20040928000526 |
| Provider Name | Michael R Frogley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1316126741 PECOS PAC ID: 6709968803 Enrollment ID: I20080129000192 |
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