| Canyon Care Llc | |
|
10160 E State Highway 210 Ste 2 Alta UT 84092-9509 | |
| (801) 742-9820 | |
| Not Available |
| Full Name | Canyon Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 10160 E State Highway 210 Ste 2, Alta, Utah |
| Authorized Official Name and Position | Kenneth P Libre (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8017429820 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Care Llc Po Box 8072 Alta UT 84092-8072 Ph: (801) 742-2273 | Canyon Care Llc 10160 E State Highway 210 Ste 2 Alta UT 84092-9509 Ph: (801) 742-9820 |
| NPI Number | 1417509860 |
|---|---|
| Provider Enumeration Date | 07/15/2019 |
| Last Update Date | 07/15/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417509860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |