| Utah Valley Senior Medicine | |
|
395 W Cougar Blvd Ste 602 Provo UT 84604-3331 | |
| (801) 357-7250 | |
| Not Available |
| Full Name | Utah Valley Senior Medicine |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 395 W Cougar Blvd Ste 602, Provo, Utah |
| Authorized Official Name and Position | Mark Briesacher (SVP - CHIEF PHY EXECUTIVE) |
| Authorized Official Contact | 8014423495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Utah Valley Senior Medicine Po Box 27128 Salt Lake City UT 84127-0128 Ph: (801) 373-3300 | Utah Valley Senior Medicine 395 W Cougar Blvd Ste 602 Provo UT 84604-3331 Ph: (801) 357-7250 |
| NPI Number | 1851807333 |
|---|---|
| Provider Enumeration Date | 12/20/2017 |
| Last Update Date | 01/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851807333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
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