Acqua Medical Llc is a health care provider in Salt Lake City, UT. In this page you will find its mailing address, practice location, phone number, specialty etc.
|Practice Location||100 N Johnson Mill Rd, Midway, UT 84049-6764, US|
|Practice Location Phone||844-654-3700|
|Practice Location Fax||801-926-1133|
|Legal Business Name||ACQUA MEDICAL LLC|
|Enumeration Date ?||Mar 29, 2017|
|Last Update Date ?||Jun 20, 2018|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
|Specialty||Provider Type||Specialization||License||License State|
|Psychiatry & Neurology||Allopathic & Osteopathic Physicians||Addiction Medicine|
|Family Medicine||Allopathic & Osteopathic Physicians||Addiction Medicine||293281-1205||Utah|
|Provider Id||Issuer State||Issuer Type||Issuer|
An authorized official is an appointed official with the legal authority to make changes and/or updates to the Acqua Medical Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).
|Authorized Official||Clint Tolman|
|Authorized Official Title/Position||ADMINISTRATIVE DIRECTOR|
|Authorized Official Phone Number||844-654-3700|