| Moonlighting Inc | |
|
14728 Pristine Dr Draper UT 84020-7642 | |
| (801) 599-3450 | |
| Not Available |
| Full Name | Moonlighting Inc |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 14728 Pristine Dr, Draper, Utah |
| Authorized Official Name and Position | Layne Kilpatrick (PRESIDENT, CEO) |
| Authorized Official Contact | 8015993450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moonlighting Inc Po Box 1344 Draper UT 84020-1344 | Moonlighting Inc 14728 Pristine Dr Draper UT 84020-7642 Ph: (801) 599-3450 |
| NPI Number | 1366758591 |
|---|---|
| Provider Enumeration Date | 08/25/2010 |
| Last Update Date | 08/25/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366758591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | () | Primary |
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