Utah Weight Loss, LLC

NPI #1720447766 in Provo, Utah

Provider Information

NPI Number: 1720447766
Entity Type: Organization
Organization Name: Utah Weight Loss, LLC
Primary Specialty: Dietary Manager
Enumeration Date: Feb 18, 2016
Last Updated: Feb 18, 2016

Practice Location

Address: 1055 N 300 W STE 302
City: Provo
State: Utah
ZIP Code: 84604-3373
Phone: (801) 852-3468

Authorized Official

Name: MR. ED RASMUSSEN
Title: ADMINISTRATOR
Phone: (801) 374-9625

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietary Manager	132700000X	Primary

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