Brightside Services | |
4227 S Highland Dr Ste 7 Holladay UT 84124-2672 | |
(435) 200-9965 | |
(801) 553-2540 |
Full Name | Brightside Services |
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Speciality | Family Medicine |
Location | 4227 S Highland Dr Ste 7, Holladay, Utah |
Authorized Official Name and Position | Cody Walker (OWNER) |
Authorized Official Contact | 4352009965 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Brightside Services 4227 S Highland Dr Ste 7 Holladay UT 84124-2672 Ph: (435) 200-9965 | Brightside Services 4227 S Highland Dr Ste 7 Holladay UT 84124-2672 Ph: (435) 200-9965 |
NPI Number | 1265211221 |
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Provider Enumeration Date | 09/27/2023 |
Last Update Date | 10/20/2023 |
Medicare PECOS PAC ID | 5395198394 |
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Medicare Enrollment ID | O20240125003879 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265211221 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Christopher T Romney |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386223055 PECOS PAC ID: 3274934682 Enrollment ID: I20210623000913 |
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