NPI 1124641576 · live from the CMS NPI Registry
A Larsen Wellness PC
Clinic/Center, Dental in Orem, UT. National Provider Identifier 1124641576, active.
NPI record
| NPI | 1124641576 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Dental 261QD0000X |
| Practice location | 812 S State St, Orem, UT 84097 |
| Practice phone | 801-691-7365 |
| Enumerated | May 20, 2020 |
| Last updated | May 20, 2020 |
| Authorized official | Corbin Cowan, Ceo |
| Other names | Neuvo Wellness |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | — |
| Dentist, Dentist Anesthesiologist Speciality | 1223D0004X | — |
| Clinic/Center, Dental primary | 261QD0000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.