| South Cache Valley Clinic | |
|
550 E 1400 N Ste X Logan UT 84341-2782 | |
| (435) 792-1600 | |
| Not Available |
| Full Name | South Cache Valley Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 550 E 1400 N Ste X, Logan, Utah |
| Authorized Official Name and Position | Linda C Leckman (CEO INTERMOUNTAIN MEDICAL GROUP) |
| Authorized Official Contact | 8014423974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Cache Valley Clinic Po Box 27128 Salt Lake City UT 84127-0128 Ph: (435) 792-1600 | South Cache Valley Clinic 550 E 1400 N Ste X Logan UT 84341-2782 Ph: (435) 792-1600 |
| NPI Number | 1982748737 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 07/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982748737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3087 (Utah) | Primary |
| 207V00000X | Obstetrics & Gynecology | 3087 (Utah) | Secondary |
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