| 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 |
|---|---|
| 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 |