| Provider Services Network, Inc. | |
|
765 E 340 S Ste 206 American Fork UT 84003-3310 | |
| (801) 893-1130 | |
| Not Available |
| Full Name | Provider Services Network, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 765 E 340 S Ste 206, American Fork, Utah |
| Authorized Official Name and Position | Paul Ewing (CEO) |
| Authorized Official Contact | 8018452222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provider Services Network, Inc. 5513 W 11000 N # 535 Highland UT 84003-8012 Ph: () - | Provider Services Network, Inc. 765 E 340 S Ste 206 American Fork UT 84003-3310 Ph: (801) 893-1130 |
| NPI Number | 1225658800 |
|---|---|
| Provider Enumeration Date | 04/23/2020 |
| Last Update Date | 04/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225658800 | NPI | - | NPPES |
| 10995695-0142 | Other | UT | STATE OF UTAH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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