| Rivendell Clinic Llc | |
|
1381 Alpine Loop Provo UT 84606-5300 | |
| (385) 446-5010 | |
| Not Available |
| Full Name | Rivendell Clinic Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 1381 Alpine Loop, Provo, Utah |
| Authorized Official Name and Position | Sarah Ingerson (DR) |
| Authorized Official Contact | 3859858423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivendell Clinic Llc 826 Expressway Ln Unit 746 Spanish Fork UT 84660-1300 Ph: (385) 446-5010 | Rivendell Clinic Llc 1381 Alpine Loop Provo UT 84606-5300 Ph: (385) 446-5010 |
| NPI Number | 1326745787 |
|---|---|
| Provider Enumeration Date | 02/15/2023 |
| Last Update Date | 02/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326745787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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