Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 1915 W 5950 S, Roy, Utah |
Authorized Official Name and Position | Kelly J Howard (DIRECTOR) |
Authorized Official Contact | 8014421425 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 27128 Salt Lake City UT 84127-0128 Ph: (801) 442-1400 | 1915 W 5950 S Roy UT 84067-1454 Ph: (801) 387-5620 |
NPI Number | 1588802482 |
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Provider Enumeration Date | 01/30/2009 |
Last Update Date | 01/30/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588802482 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Family Tree Preventative Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5185 S 2275 W, Roy, UT 84067 Phone: 801-698-2144 | |