Bridge Utah Medical Group | |
1015 E 100 N Logan UT 84321-4873 | |
(888) 221-0423 | |
(888) 221-9816 |
Full Name | Bridge Utah Medical Group |
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Speciality | Physical Medicine & Rehabilitation |
Location | 1015 E 100 N, Logan, Utah |
Authorized Official Name and Position | Cameron G Peterson (CHIEF MEDICAL OFFICER, MANAGING PAR) |
Authorized Official Contact | 8015988337 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bridge Utah Medical Group Po Box 1468 Bountiful UT 84011-1468 Ph: (888) 853-8973 | Bridge Utah Medical Group 1015 E 100 N Logan UT 84321-4873 Ph: (888) 221-0423 |
NPI Number | 1104324904 |
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Provider Enumeration Date | 01/26/2018 |
Last Update Date | 03/14/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104324904 | NPI | - | NPPES |
0000 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
Ihc Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 550 E 1400 N Ste Xy, Logan, UT 84341 Phone: 435-757-1315 | |