| Rivendell Clinic Llc | |
|
3507 N University Ave Ste 350f Provo UT 84604-4478 | |
| (385) 446-5010 | |
| (385) 446-5012 |
| Full Name | Rivendell Clinic Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 3507 N University Ave Ste 350f, Provo, Utah |
| Authorized Official Name and Position | Sarah Ingerson (DR) |
| Authorized Official Contact | 3859858423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivendell Clinic Llc 3507 N University Ave Ste 350f Provo UT 84604-4478 Ph: (385) 446-5010 | Rivendell Clinic Llc 3507 N University Ave Ste 350f Provo UT 84604-4478 Ph: (385) 446-5010 |
| NPI Number | 1326745787 |
|---|---|
| Provider Enumeration Date | 02/15/2023 |
| Last Update Date | 12/03/2025 |
| Certification Date | 12/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326745787 | NPI | - | NPPES |
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