Provider Information for 1649563495
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ROBYN THORSTED
Sex: Female
NPI: 1649563495
Last Updated: 2024-03-12
Certification Date: 2024-03-12
Certification Date: 2024-03-12
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1649563495 | ||||||||||||
| Enumeration Date | 2011-05-25 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 221 HONEYVILLE, UT 84314-0221 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 971 S 800 W BRIGHAM CITY, UT 84302-3042 United States Phone: 435-681-3110 | Fax: | ||||||||||||
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