NPI 1720447766

Utah Weight Loss, LLC

Organisation Dietary Manager Provo, UT

Practice location

Address: 1055 N 300 W STE 302, Provo, UT 84604-3373
Phone: (801) 852-3468
Fax: (801) 852-3459
Mailing address: 3550 N University Ave STE 250, Provo, UT 84604-6685

Authorised official

Name: Ed Rasmussen
Title: Administrator
Phone: (801) 374-9625

Registered specialties

Dietary Manager Primary

Dietary & Nutritional Service Providers Taxonomy 132700000X Licence 283029-1205 (UT)

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Registry record

NPI: 1720447766
Entity type: Organization
NPI issued: 18 Feb 2016
Record last updated: 18 Feb 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.