NPI 1205377736

Passport Health Holdings, LLC

Organisation Public Health & General Preventive Medicine Physician Provo, UT

Practice location

Address: 1055 North 300 West STE 416, Provo, UT 84604-3354
Phone: (877) 358-8648
Fax: (877) 877-6875
Mailing address: 8324 E Hartford Dr STE 200, Scottsdale, AZ 85255-7801

Authorised official

Name: Doug Shackell
Title: Director of Finance
Phone: (480) 646-9024

Registered specialties

Public Health & General Preventive Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083P0901X

Other Preventive Medicine providers in Utah →

Registry record

NPI: 1205377736
Entity type: Organization
NPI issued: 16 Mar 2017
Record last updated: 16 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.