Cache Valley Medical and Wellness

NPI #1790087559 in Logan, Utah

Provider Information

NPI Number: 1790087559
Entity Type: Organization
Organization Name: Cache Valley Medical and Wellness
Primary Specialty: Clinic/Center
Enumeration Date: Nov 30, 2010
Last Updated: Nov 30, 2010

Practice Location

Address: 196 S 100 W
City: Logan
State: Utah
ZIP Code: 84321-5233
Phone: (435) 755-0434

Authorized Official

Name: DR. BENITA JO QUAKENBUSH-ROBERTS, PH.D.
Title: CEO
Phone: (435) 755-0434

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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