| Illuminate Holdings Llc | |
|
14884 S Heritagecrest Way Ste D Bluffdale UT 84065-4840 | |
| (801) 793-0620 | |
| Not Available |
| Full Name | Illuminate Holdings Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 14884 S Heritagecrest Way Ste D, Bluffdale, Utah |
| Authorized Official Name and Position | Shelley Mangum (SVP) |
| Authorized Official Contact | 8017930620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminate Holdings Llc 510 E Sego Lily Dr Sandy UT 84070-3546 Ph: () - | Illuminate Holdings Llc 14884 S Heritagecrest Way Ste D Bluffdale UT 84065-4840 Ph: (801) 793-0620 |
| NPI Number | 1285315176 |
|---|---|
| Provider Enumeration Date | 07/25/2023 |
| Last Update Date | 07/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285315176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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