| Independence Physician And Resource | |
|
640 S 500 W Bountiful UT 84010-7210 | |
| (801) 298-1100 | |
| (801) 298-1988 |
| Full Name | Independence Physician And Resource |
|---|---|
| Speciality | General Practice |
| Location | 640 S 500 W, Bountiful, Utah |
| Authorized Official Name and Position | Daniel Frasure (MANAGING PARTNER) |
| Authorized Official Contact | 8016988927 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Physician And Resource 640 S 500 W Bountiful UT 84010-7210 Ph: (801) 298-1100 | Independence Physician And Resource 640 S 500 W Bountiful UT 84010-7210 Ph: (801) 298-1100 |
| NPI Number | 1851785919 |
|---|---|
| Provider Enumeration Date | 03/26/2015 |
| Last Update Date | 04/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851785919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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