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674 S Highway 99 Fillmore UT 84631-5013 | |
(435) 743-5591 | |
(435) 743-6312 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 674 S Highway 99, Fillmore, Utah |
Authorized Official Name and Position | Denis Smith (CFO) |
Authorized Official Contact | 8014422000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4646 Lake Park Blvd Salt Lake City UT 84120-8212 Ph: (801) 442-8468 | 674 S Highway 99 Fillmore UT 84631-5013 Ph: (435) 743-5591 |
NPI Number | 1851338495 |
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Provider Enumeration Date | 06/01/2006 |
Last Update Date | 11/16/2022 |
Identifier | Type | State | Issuer |
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1851338495 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | 2005HOSP25387 (Utah) | Primary |