Diamond Springs Wellness Center PC
Organization Active NPI Family Medicine Physician · Midway, UT
NPI 1780980391 · NPPES record last updated Jan 28, 2011
Key facts
- NPI
- 1780980391
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 180388-1204 (UT)
- Legal business name
- DIAMOND SPRINGS WELLNESS CENTER PC
- Practice address
- 210 E Main St
Suite 101
Midway, UT 84049-6806 - Phone
- (435) 657-1777
- Fax
- (435) 657-0098
- NPI assigned
- Jan 28, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Judith S Moore, D.O.
- Title
- Owner
- Phone
- (435) 657-1777
Corporate family (same tax ID) 1
Practitioners 4
-
Sarah E. Firmage, L.AC
-
Beth Ann Haggett, LCSW, PHD
-
Judith S Moore, DO
-
Henry A. Malus, N.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 46D2019537 | Diamond Springs Wellness Center PC | Certificate of waiver | Jan 31, 2027 |
National Provider Directory
- Tax ID family
- Diamond Springs Wellness Center
Locations
210 E Main St
Ste 101
Midway, UT 84049
Phone (435) 657-1777
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 180388-1204 | UT | Yes |
Addresses
Primary practice location
210 E Main St
Suite 101
Midway, UT 84049-6806
Mailing address
210 E Main St
Suite 101
Midway, UT 84049-6806
Phone (435) 657-1777
Other providers in Midway, UT
- Cascade Academy
- Neil Drew Christensen
- ZD Chudyba
- Krista Jean Clark
- Jack L Cox
- Spencer N Diehl
- Duane E Townsend a Professional Corporation
- Kathy Felt
- Sarah E. Firmage
- Anna Fisher
All providers in Midway, UT · Family Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.