| Embracing Authenticity Inc | |
|
95 Golf Course Rd Ste 105 Logan UT 84321-5990 | |
| (435) 915-6398 | |
| Not Available |
| Full Name | Embracing Authenticity Inc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 95 Golf Course Rd Ste 105, Logan, Utah |
| Authorized Official Name and Position | Carly D.l. Lebaron (PRESIDENT/CEO) |
| Authorized Official Contact | 4359156398 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Embracing Authenticity Inc 576 N 470 E Providence UT 84332-8901 Ph: (435) 764-5186 | Embracing Authenticity Inc 95 Golf Course Rd Ste 105 Logan UT 84321-5990 Ph: (435) 915-6398 |
| NPI Number | 1558129221 |
|---|---|
| Provider Enumeration Date | 03/07/2024 |
| Last Update Date | 03/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558129221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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