| Sage Functional Medicine Center | |
|
55 E 100 N Suite 303 Logan UT 84321-4661 | |
| (435) 760-7078 | |
| Not Available |
| Full Name | Sage Functional Medicine Center |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 55 E 100 N, Logan, Utah |
| Authorized Official Name and Position | Lisa Shea Roberts (OWNER/OPERATOR) |
| Authorized Official Contact | 4357607078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Functional Medicine Center 55 E 100 N Suite 303 Logan UT 84321-4661 Ph: (435) 760-7078 | Sage Functional Medicine Center 55 E 100 N Suite 303 Logan UT 84321-4661 Ph: (435) 760-7078 |
| NPI Number | 1912368549 |
|---|---|
| Provider Enumeration Date | 03/09/2016 |
| Last Update Date | 03/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912368549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 8689112-4405 (Utah) | Primary |
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