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1160 S State St Ste 160a Orem UT 84097-8263 | |
| (801) 602-2645 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1160 S State St Ste 160a, Orem, Utah |
| Authorized Official Name and Position | Kyunghee Seo (MS. K) |
| Authorized Official Contact | 8016022645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1160 S State St Ste 160a Orem UT 84097-8263 Ph: (801) 602-2645 | 1160 S State St Ste 160a Orem UT 84097-8263 Ph: (801) 602-2645 |
| NPI Number | 1750928214 |
|---|---|
| Provider Enumeration Date | 12/04/2019 |
| Last Update Date | 05/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750928214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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