NPI 1316330749
Central Utah Clinic, P.C.
Practice location
- Address
- 1055 N 500 W STE 202, Provo, UT 84604-3305
- Phone
- (801) 374-2367
- Fax
- (801) 429-8015
- Mailing address
- 1055 N 500 W Attn: Credentialing, Provo, UT 84604-3305
Authorised official
- Name
- Jed Harston
- Title
- Director of Managed Care
- Phone
- (801) 812-5012
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1316330749
- Entity type
- Organization
- NPI issued
- 10 Mar 2015
- Record last updated
- 16 Jun 2018
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.