person
Marvon Shane Holdaway, CM
Substance Use Disorder Rehabilitation Clinic/Center in Mount Pleasant, Utah
NPI 1053045898

Marvon Shane Holdaway is a Substance Use Disorder Rehabilitation Clinic/Center based in Mt Pleasant, UT and is specialized in Rehabilitation, Substance Use Disorder. Marvon Shane Holdaway practices in Mount Pleasant, UT and has the professional credentials of CM. The NPI Number for Marvon Shane Holdaway is 1053045898 and holds a License No. (Utah).

The current practice location address for Marvon Shane Holdaway is 265 N State St, Mount Pleasant, UT and can be reached out via phone at 435-462-2781 and via fax at 435-462-0155.

Location: 265 N State St, Mount Pleasant, UT, 84647-0031
person
Provider Profile Details
NPI Number
1053045898
Provider Name
Marvon Shane Holdaway
Credential
CM
Provider Entity Type
Individual
Gender
Male
Address
265 N State St, Mount Pleasant, UT, 84647-0031
Phone Number
435-462-2781
Fax Number
435-462-0155
Provider Enumeration Date
07/15/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
HT007021-001 05 UT
institution
Provider Business Practice Location Address Details
Address
265 N State St
City
State
Zip
84647-1108
Phone Number
435-462-2781
Fax Number
435-462-0155
person
Provider Business Mailing Address Details
Address
265 N State St
City
State
Zip
84647-1108
Phone Number
435-462-2781
Fax Number
435-462-0155
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
License No.
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Definition
Definition to come...
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