| Wasatch G O D Medical Llc | |
|
2480 S Main St Ste 108 South Salt Lake UT 84115-5002 | |
| (385) 612-1794 | |
| Not Available |
| Full Name | Wasatch G O D Medical Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2480 S Main St Ste 108, South Salt Lake, Utah |
| Authorized Official Name and Position | Tyree Knight (MANAGER) |
| Authorized Official Contact | 3856121794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wasatch G O D Medical Llc 2480 S Main St Ste 108 South Salt Lake UT 84115-5002 Ph: (385) 612-1794 | Wasatch G O D Medical Llc 2480 S Main St Ste 108 South Salt Lake UT 84115-5002 Ph: (385) 612-1794 |
| NPI Number | 1114897345 |
|---|---|
| Provider Enumeration Date | 11/11/2025 |
| Last Update Date | 11/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114897345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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