| Vivint Medical Clinic | |
|
4907 North 300 West Provo UT 84604-8460 | |
| (801) 705-8040 | |
| (801) 765-5740 |
| Full Name | Vivint Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 4907 North 300 West, Provo, Utah |
| Authorized Official Name and Position | Darce Latsis (OPERATIONS MANAGER) |
| Authorized Official Contact | 8017058040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivint Medical Clinic 560 S 300 E Ste 275 Salt Lake City UT 84111-3586 Ph: (801) 441-1002 | Vivint Medical Clinic 4907 North 300 West Provo UT 84604-8460 Ph: (801) 705-8040 |
| NPI Number | 1265942163 |
|---|---|
| Provider Enumeration Date | 10/05/2017 |
| Last Update Date | 01/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265942163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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