In Home Provider | |
2432 Concord Ave Santa Clara UT 84765-5621 | |
(435) 659-7352 | |
Not Available |
Full Name | In Home Provider |
---|---|
Speciality | Family Medicine |
Location | 2432 Concord Ave, Santa Clara, Utah |
Authorized Official Name and Position | Shane Whittier (COO) |
Authorized Official Contact | 4357098786 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
In Home Provider 387 W 100 S Heber City UT 84032-1835 Ph: (435) 671-3285 | In Home Provider 2432 Concord Ave Santa Clara UT 84765-5621 Ph: (435) 659-7352 |
NPI Number | 1871131623 |
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Provider Enumeration Date | 12/11/2019 |
Last Update Date | 12/11/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871131623 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |