| |
409 S 200 E Roosevelt UT 84066-3314 | |
(435) 725-3327 | |
(435) 725-3331 |
Full Name | |
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Speciality | Family Medicine |
Location | 409 S 200 E, Roosevelt, Utah |
Authorized Official Name and Position | Charlotte Lawrence (SECRETARY) |
Authorized Official Contact | 6159207000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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409 S 200 E Roosevelt UT 84066-3314 Ph: (435) 725-3327 | 409 S 200 E Roosevelt UT 84066-3314 Ph: (435) 725-3327 |
NPI Number | 1518247709 |
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Provider Enumeration Date | 08/19/2011 |
Last Update Date | 09/18/2024 |
Identifier | Type | State | Issuer |
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1518247709 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |