| Daniel B. Vine, Md, Pc | |
|
3980 S 700 E #23 Salt Lake City UT 84107-2188 | |
| (801) 288-1115 | |
| (801) 288-1116 |
| Full Name | Daniel B. Vine, Md, Pc |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 3980 S 700 E, Salt Lake City, Utah |
| Authorized Official Name and Position | Daniel B Vine (MD) |
| Authorized Official Contact | 8012881115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel B. Vine, Md, Pc 3980 S 700 E #23 Salt Lake City UT 84107-2188 Ph: (801) 288-1115 | Daniel B. Vine, Md, Pc 3980 S 700 E #23 Salt Lake City UT 84107-2188 Ph: (801) 288-1115 |
| NPI Number | 1699075895 |
|---|---|
| Provider Enumeration Date | 10/22/2010 |
| Last Update Date | 10/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699075895 | NPI | - | NPPES |
| 527270415025 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 171413-1205 (Utah) | Primary |
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