| Ashley Valley Physician Practice, Llc | |
|
409 S 200 E Roosevelt UT 84066-3314 | |
| (435) 725-3327 | |
| (435) 725-3331 |
| Full Name | Ashley Valley Physician Practice, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 409 S 200 E, Roosevelt, Utah |
| Authorized Official Name and Position | Charlotte Lawrence (SECRETARY) |
| Authorized Official Contact | 6159207000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashley Valley Physician Practice, Llc 409 S 200 E Roosevelt UT 84066-3314 Ph: (435) 725-3327 | Ashley Valley Physician Practice, Llc 409 S 200 E Roosevelt UT 84066-3314 Ph: (435) 725-3327 |
| NPI Number | 1518247709 |
|---|---|
| Provider Enumeration Date | 08/19/2011 |
| Last Update Date | 09/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518247709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Uintah Basin Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 250 W 300 N, Roosevelt, UT 84066 Phone: 435-725-7448 Fax: 435-722-9291 | |
Ashley Valley Physician Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 409 S 200 E, Roosevelt, UT 84066 Phone: 435-781-0757 Fax: 435-781-2628 |